ASSIGNMENT: Expository Essay

ESSAY TITLE:  Nursing Informatics Improves Healthcare Efficiency in

Terms

Of   Quality, Safety, and Cost, but Technology is not Without Risks

COURSE CODE: NURS 337

COURSE TITLE: Nursing Informatics

CRN:19745             LECTURER’S NAME: Ms. A. Walker

 

                            GROUP MEMBERS

STUDENT NAME STUDENT I.D.

1. Anisha Gopaul 0006205

2. Camille Ross-London 00065609

3. Christen Santana 00064181

Nursing
4. Cindy Richardson 00066632
Informatics
5. Lea Springer 00066750
Improves
6. Leona Collins 00067315
Health Care Efficiency in Terms of Quality, Safety, and Cost, but Technology is not Without

Risks

Although Nursing Informatics can be traced back to the 1960’s, the first

undergraduate program was established in 1988 by the University of Maryland and has since

been updated at regular intervals. Nursing Informatics is defined as the combination of

nursing science, information and management science, and computer science to manage or

process nursing data, information and knowledge to deliver quality patient care. Nursing

Informatics is becoming progressively present in healthcare, as a result of the constant

evolution of technology. Most healthcare providers have already assimilated technology into

their daily practice. Nursing Informaticians have access to electronic health records (EHR),

diagnostics, and treatment plans. Documentation is one of the many ways informatics has

modified nursing practice. The use of computers and smart devices makes retrieval and input

of patient’s information less cumbersome Effective communication mediums to increase the

management of healthcare workflow, enhance coordination, and refine patient care. System

integration allows information to be examined and processed expeditiously. The coalition of

Informatics along with evidence-based practice (EBP) can improve patient care. The

additional data that is generated can be analysed, and future patient outcomes can be

improved .While technology may be a convenient and efficient method of simplifying life, it

can also be disastrous. When equipment malfunctions, it can temporarily or permanently

derail operations. This requires specialized personnel (that are not always readily available)

to rectify the problem. An unreliable internet source or breakdown in connectivity is another

factor that can bring healthcare to a standstill. Patients' personal information can be

compromised by computer hackers. Also the cost to set up the equipment can be costly, and

healthcare workers would require training healthcare workers would require training. Some

workers experience technophobia (the fear or dislike of advanced technology). Perhaps one

of the greatest downfalls of technology is the excessive dependency on technology to

complete tasks. This essay seeks to identify ways in which Nursing Informatics improves

health care efficiency in terms of quality, safety, and cost, while also focusing on the risks

associated with technology

Similarly as the world of work embraced the technology era the health care system

was not left far behind. The acceleration of computerize systems in the healthcare system in

the 1970’s, nursing began to understand the importance of computers to the nursing

profession and how it will impact nursing care. As technology evolves nursing informatics

become involved in the design, implementation of information systems to improve patient

care. Many organisations became involved in the impact of technology on nursing care for

example Institute of Medicine (IOM) created several reports which provided evidence for the

of technology as a tool to supply a more secure, more efficient healthcare conveyance

framework together with workforce planning which would empower healthcare experts to

utilize that innovation to get indicated benefits . These IOM reports included To Err is

Human: Creating and defining a Safer Health System (1999), passing the Quality Chasm: An

Updated Health System for the 21st Century (2001), and Patient Safety: Changing the

Working Environment for Nurses (2004). The many benefits to  having computerize and

information systems  includes reducing potentials errors, access timely and relevant patient

information, enhance continuity of care,  language will be standardized, enabling cost saving

and productivity goals, improve communication in the interdisciplinary team, allow nurses to

have more time for nursing and quality time for patients, reduce the long hours for patients at

clinics waiting for medical care, reduces the storage area and provide effect retrieval of

patients medical records, the transmission of drug prescriptions from hospital based too

impatient ordering system. Other benefits of robotization are the utilization of computer
programs that can compose data to help in choice making for client care or regulatory issues

for example references for databases, medical caretakers can effortlessly overhaul their

information of data on drugs, maladies and medications as portion of the mechanized

framework. The administration of data and the capacity to supply chronicled or

current information reports will work proficiently .Information and data related to treatment

such as the period of hospitalization and the most reduced level of care provider required may

well be utilized to diminish costs for the patient. Inventory is updated and alarms are placed

to alert low levels of stock. Therefore the benefits for technology in the healthcare system can

benefit not only the patients but the healthcare team in making the delivery of healthcare

systems efficient.

 Quality in healthcare has improved as a result of nursing Informatics. New and evolving

technologies have transfigured healthcare. Both hospital and private medical practice large

and small have enforced new technologies to respond to a mobile regulatory environment.

There are many tools that guarantee this, one of these tools include information technology

(IT). This system ensures fewer errors, conforms to today’s regulations, and allows for

speedy recovery from unforeseen tragedies. Health care providers utilise IT tools for daily

operation of the health care facility .Using this applied science will improve patient

outcomes, and add quality and efficiency to healthcare. To ensure these outcomes, electronic

health records (EHR) are used, via Health Information exchange (HIE) platform. EHR is a

comparison of a patient’s information. EHR’s, make information accessible and secure to

authoritative users. The EHR contains the patient’s medical information, allows access to

evidenced based tools about the patient’s care, also automates and expedites provider

workflow. EHRs reduce paperwork, assist the health care team to promote patient care and

protect safety, moreover, give access to health records and reduce unnecessary tests and

procedures. Documentation is important; it is a vital skill in the exchange of information

relating to the condition of the patient, and organises treatment in accordance to his/her

needs. IT assists the nurse in assembling information in a timely manner, improves accuracy

of patient information, and enhances the quality of patient care. This skilfully designed

system promotes and allows easy and fast information flow needed for systemized

documenting and processing. Electronic patient records have become important aspects of

information workflow. The manoeuvring of client information to EHR systems can be

accessed via the health information exchange (HIE). This is automated system to system

information exchange that presents information to clinicians when needed. The key technical

intelligence which creates structure to the HIE, also supports transfer of patient information

inclusive of, master patient index, integration engine and clinical data repository. The master

index consists of a database, and is a distinct identifier for every patient whose information

has been received by (HIE). Integration engine is a combined machine, which allows one way

and two way interfaces, query responses, and also interacts with E- health exchange, it also

distributes alerts and notifications, In addition, it provides the means to edit, transform, and

map data between formats. Clinical data repository consists of complete databases, that

houses all patient demographic and data transactions, received by the HIE. Moreover, these

remain in original format with their original content.  Health IT generated data is powerful in

initially inspiring quality in health care.

Patient safety is a priority when it comes to nursing informatics

especially since medical caretakers are habitually the ones guaranteeing that patients are

kept secure and maintaining a strategic distance from medication blunders, falls and other

issues. Nursing informatics plays a major part within the usage of electronic health records

(EHR) as well as the designing and training of others in the utilization of EHR’s. Health care

efficiency in terms of safety has made strides due to nursing informatics through the use of

technology such as; bar codes, computerized order entry systems, decision-support systems,
smart IV pumps and electronic health records (EHR). Patient safety covers patient contact

completely from the starting of the visit at registration to the follow-up after discharge.

Informatics helps plan the questions that are asked at registration, where patient-identifying

information is collected. Accurate recognizable proof of patients and their condition is critical

to guarantee the correct care is given. Also, nursing informatics permits for transparency in

direct care nursing documentation. Transparency alludes to the clarity of the record for its

users, these permits for clear and open sharing of data among health care providers as well as

improved communication to avoid medical errors (Lavin et al., 2015). In addition, the bar

code medication administration technology in conjunction with decision support systems, at

the point of care, provide information, support clinical decisions and give alerts, which

ultimately help safe behaviours and decision making. With real time alerts, this avoids

medication errors and adverse events. This system, implemented within the EHR, maximizes

the security of and decreases errors in prescribing, transcribing, dispensing and

administration of medicine (Lavin et al., 2015). Medication Bar code scanning on patient’s

armbands and medications not only guarantees the right medication is given to the right

patient; but moreover, alerts to the medical provider and the nurse to caution of potential

issues with dose, drug interactions, allergies and contraindications prior to giving

medications, as well as, lab values, radiology results, or pharmacy drug alerts that might

cause harm. Furthermore, the use of smart IV pumps helps to avoid drug errors. It permits for

calculating and programming of drug’s dose and delivery rates and contain special drug error

reduction programs. Additionally, hard stops are implemented that prevent staff from moving

forward within the record. This permits staff to fill out data at critical stages, such as blood

transfusion data, preoperative data, and other potential risk areas. 

Nursing informatics specialists use technology such as electronic health records,

mobile application, social networking, robotics and nanotechnology to improve nursing

competence and practice to operate efficiency and communicate more effectively. These

technologies are quite costly but it can also improve health care by saving the government a

lot of money.  For example it would be expensive for the government to purchase computers

for each ward in the hospital; however, by purchasing these computers, with Electronic

Health Records (EHR) software, it can also lower the cost the government has to spend on

healthcare and save a lot of money by reducing the occurrence of errors and purchasing less

stationary.  According to the American Association for Justice (AAJ), there are reports that

the Institute of Medicine (IOM) estimates that up to 98,000 deaths occur due to preventable

medical errors ("Medical Errors", n.d.). In addition, the Institute of Medicine (IOM) also

estimates that medical errors cost the U.S. around $38 billion each year ("4 Ways Health

Informatics Improves Patient Care | UIC Health Informatics'', n.d.). However, with the EHR

system it prevents human errors thus reducing cost. Patients are now able to receive the right

medication at the first time to prevent allergic reactions to antibiotics and other medicines.

Also before the physician prescribing a specific medication it shows dangerous interactions

the patient had with the medication. These EHR systems take human error out of the

equation. This forum gives all healthcare professionals a broad picture of clients' past medical

history, current health condition and allows for quick update of patients information without

having to wait on patient’ paper based records. These systems allow for quick and easy

access of patient’s medical records which makes it easier for health care providers to properly

analyse patient health conditions resulting in less trial and error.  In terms of purchasing less

stationary, EHR replaces paper documents, such as patient’s notes, medication sheets, input

and output charts, lab results, diagnostic test results etc, which the nurses and other

practitioners use, with a paperless environment which reduces cost of purchasing stationary

considerably. Moreover, with the EHR system nurses no longer need to go through thick

notes to get patient’s information and no longer need to understand what the doctor wrote in
the patient’s file, thus reducing error as well as cost. In my opinion technology is important

for the long run of health care costs, even if it means paying more upfront today.

There are many risks when using technology especially in healthcare. These risks go

from a general point of view such as electronic storage of information which renders it more

vulnerable to security breaches and hackers, healthcare practitioners can become over-reliant

on electronic records and forget how to work without them, errors can also arise from the

entry of incorrect numbers or typos and the machine may have gone down or faced

technological problems resulting in problems in the workplace. There were also specific risks

that stood out, they are "Alarm Fatigue" hazards; the alarms on medical equipment, such as

infusion pumps, ventilators and dialysis machines, are programmed to alert patients of

possible hazards. But alarms may lead to harmful events. And anaesthesia dangers from

mistakes in pre-use inspection. This can cause significant complications with anaesthesia

instruments. Reports contain disconnected ventilation loops, leaking of the ventilator and

hollow gas cylinders. There are exposure dangers from radiation therapy and CT; while it can

be life-saving it can also have catastrophic effects if mistakes occur. Similarly, improper use

and dosage amounts of CT will lead to excessive exposure to radiation in patients. 

In retrospect, nursing informatics has many benefits for nursing practice, along with

increasing the quality of healthcare, and patient safety however the technologies needed are

expensive and have many risks associated with them. The benefits of implementing

information systems are to make nursing practice and healthcare delivery more efficient and

safer as it reduces human errors, it increases the efficiency of information accessibility,

allows smooth continuity of patient care, having a standardized language and reducing

clerical duties do nurses have more time with patients. By implementing technology it is

beneficial to both the healthcare professionals and patients. Nursing informatics aims to

improve patient safety with the implementation and proper training in the use of electronic
health records (EHR) in addition to many other technologies like bar codes, order entry

systems, decision-support systems, smart IV pumps and real time alerts for when errors

happen or adverse events. The technologies implemented that aim to improve patient safety

from the moment they are admitted, all the way through stay in hospital to discharge.  While

technology used for nursing informatics is very beneficial, they are unfortunately very

expensive to implement initially however, EHRs are very effective in reducing costs

elsewhere. Implementing EHRs will reduce costs for paper based stationery, as well reducing

human errors and make the delivery of health care more efficient which will reduce the cost

in the long run. Unfortunately, there are risks with everything, technology is no different. The

use of technology and the internet brings with it added threat of hackers, data loss due to

theft, incorrect data entry and machinery malfunctions. Based on the evidence provided in

this essay, it is clear nursing informatics is very advantageous to the nursing, nursing practice

and the delivery of healthcare as it is continuously evolving making healthcare better and of a

higher calibre while ensuring patient safety however, these technology may be expensive

initially but reduce cost later and more importantly, healthcare professional should be aware

of the risks and safeguard against them. 

 
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