Contemporary Issues in Nursing Practice

The recent changes in technology has affected and transformed almost all sectors of the economy, and the health sector is not left behind. With the recent laws in health care, federal law now requires all health care providers to move from manual systems to electronic systems in the management of health information. The health care providers are now in the process of acquiring new technological tools and moving to electronic health systems. However, there are several challenges that they need to consider before moving to the new system. The advancement in technology has facilitated the improvement of the way in which nursing related functions are carried out. Nurses are now able to provide better services to their clients with the use of electronic tools. However, the adoption of such tools is posing technological and human challenges to both the nurses and the patients (Ruland & Ravn 2009, p. 210). The field of nursing like any other professional field has undergone a revolution in terms of service delivery. The technological advancement has steadily transformed the nursing field and more sophisticated tools are being introduced in order to help nurses serve their patients well. One of the fastest growing areas in nursing is the nursing informatics that seeks to introduce nurses to technological tools and systems available to them; therefore, assist them in the delivery of not only quality services, but also ensuring that services are efficient.

Contemporary Issues in Nursing

The use of information as an essential ingredient in an information-based discipline like nursing has led to the proliferation of technologically based tools that are assisting nurses in the delivery of health services to their patients (Yi-Chang 2009, p. 26). This has also led to the development of a completely new academic branch of study known as nursing informatics that deals with the evaluation and analysis of available technological tools for nurses in the health care industry. Nursing informatics is a field that encompasses computer science, information science, and general nursing science. It is aimed at enabling nurses in “the management and processing of nursing data, information, and knowledge to support nursing practice, education, research, and administration”.


Nursing informatics itself denotes various activities that are performed by nurses to improve the management and processing of data. As noted by Wachter & Pronovost, it involves three elements that outline the structure for analysis. These elements include technology-oriented elements, conceptually oriented element, and role-oriented elements. This implies that the field encompasses an expansive area that brings new issues, which are conventionally known to be beyond the scope of nursing into the profession. Characteristically, nursing was simply known as a profession that was mainly concerned with the delivery of health care services to patients in wards. However, the expansion of the definition has meant that nurses are also supposed to know what goes on behind the curtain in terms of health information and information tools, the technology tools available, the confidentiality and security concepts as well as the data analysis software available for nurses among other necessary tools. This should not only be in theoretical perspective but also in practice.

The introduction of nursing informatics in the larger nursing profession has forced the industry to come up with a special position for nurses. This is known as nursing informatics specialist and the responsibilities assigned to him/her must be commensurate with the larger objectives of the nurses. The nursing informatics specialist performs duties such as assisting nurses in employing informatics theories, concepts, methods, and tools to analyze specific information and information system requirements. They also engage in designing, selecting, implementing, and evaluating of information systems, data structures, and decision-support mechanisms that care about patients, nurses, and their human–computer interactions within health care contexts. Besides, they are also mandated with the responsibility of facilitating the creation of new knowledge in the nursing industry.

The nursing profession has thus evolved into a whole new area of management and processing information. The hospital nursing information systems have become common tools for nurses, especially, in the retrieval and management of health records of their patients while still focusing on their main business of caring for the patients.  More research and data analysis software have also been designed to assist nurses in the delivery of their services. While these tools are important in ensuring that nurses achieve efficiency and effectiveness in their work, it is essential that they focus on the main agenda of providing their patients with high-quality services without being distracted by the tools and models that are being put in place to facilitate the delivery of services.

Several factors, in the dynamic nursing industry and the entire health industry, have also contributed to the changes that are being witnessed in the area of nursing and the provision of health care services. For instance, the adoption of electronic tools in emergency rooms is necessitated by the need to reduce medication-related errors in emergency departments and the need to improve clinical documentation and decision making in an emergency. Telehealth or telemedicine advancement in the provision of medical services also contributes to the need for different health care providers to adopt electronic tools that will facilitate this service. Charters observes that health care providers in general and nurses, in particular, are now mandated to share information in a global world where a patient can seek medical attention in whichever medical centre across the country or even in a different country. This is evidenced in high cases where nurses across borders are increasingly sharing medical information on higher levels than before. The new trend is facilitated by the use of technologically advanced tools and the knowledge acquired through nursing informatics.

While it is agreeable that nursing informatics has brought a lot of benefits to the nursing profession, it is evident that the use of concepts and technology tools in health care by nurses pose challenges to the profession. The use of electronic tools such as data analysis software and computers in nursing is essential for better services. However, it is noted that some nurses may not have the required knowledge to use such tools. Moreover, there have been cases where even their employers’ lack of resources to acquire systems in which nurses have the knowledge. In addition, some departments in nursing such as emergency rooms require tools that are robust and functional with 100% accuracy, because the department deals with saving human life. Failure in the functionality of such tools can sometimes lead to loss of life. The department’s rooms will need to have extra equipment in place to ensure that if one fails, the other can be put in place to continue serving the patient.

The issue of nurses sharing information and confidentiality with patient’s information is also challenging in a technology-based nursing environment. Since it can lead to the sharing of confidential information with unauthorized people. It is also possible for such people to access and retrieve such information without the permission of the authority and use the same against the health care center or the health care specialist. The possible solution to this challenge is to put more emphasis on the issues of privacy and security of information in the nursing field by giving health care nurses a more enhanced role to ensure that the information in their departments is protected and secured.

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Nursing Informatics

The field of nursing informatics has grown partly out of the need to keep up with the expectations of industry stakeholders on the delivery and partly as a result of the general revolution happening in the entire health industry facilitated with changing policies and the availability of technology tools. Regardless of the reason for the development of nursing informatics as an important branch in nursing, the impact of this practice on the health industry cannot be overstated. As a result of the need to provide high quality and efficiency services to clients in the health sector, nurses have had to include the use of electronic tools and software in the management and administration of data. The adoption of electronic tools in the management of records in health centers alongside the policy and procedural changes happening in health provision as well as insurance services highlights the epitome of the efforts that governments and other stakeholders in the health sector have put in place to ensure that people not only access affordable health care services, but also the services are of good quality. The nursing profession has taken lead alongside other related professionals like physicians to inculcate the use of information management systems in the delivery of services in the health industry.

The inclusion of electronic tools in the delivery of services by nurses has come both with the advantages and disadvantages. Most important is that nursing informatics has given nurses greater control in the management and evaluation of data and processes that take place in the health centers. Similarly, the use of technology has also reduced the time required to access available information in the patient’s history. It has also enhanced the safety and confidentiality of information, which has traditionally been stored in cabinets and other unsafe places. The benefits accruing from the use of technology are the management and analysis of patient records; moreover, it is also evident in the reduction in the cost of managing the records, because it gives the nurses and physicians the opportunity to update files rather than opening new ones as had been the norm in the past.

Nursing informatics has increased the cost of running a health center, especially, where the administration has to acquire electronic tools such as computers to help in the storage of information and manage them. Some of the services are outsourced to the professionals and this can escalate the overall cost of managing a hospital. The costs are normally passed down to the patient as the final consumer of the services and this is reflected in the increasing costs of treatment in hospitals and other health centers. Similarly, nurses are forced to retrain in order to be able to use the health information management systems that are put in place. The institution may also incur expenses in organizing for trains and providing the employees with knowledge and skills to use the systems put in place. Additionally, there is a perception that nursing informatics and electronic systems can lead to the collapse of the emergency services, especially, where the institution entirely depends on the electronic system like in the management and analysis of patient records. There is also the issue of confidentiality, where a person may hack the system and access the information about the management and running of the hospital.

Nursing as a profession is entwined with medicine in general. This has had an impact in the evaluation of nursing informatics and differentiated it from the medical informatics. However, with the outlining of the roles and processes that are involved in the clinical processes involving nurses, it is easier for professionals to highlight the differences between the two professionals. Whereas nursing informatics borrows heavily form medicine informatics, its distinguishing characteristics lies not in the technology used but rather in the concepts and theories, which are used in the evaluation and determination of processes in nursing. For instance, nursing informatics involves the three sciences, such as: computer science, information science, and the nursing science while medicine informatics include the pharmaceutical branch that deals with the actual medicines that physicians prescribe to their patients. Thus, the two areas are distinct from each other. Nevertheless, some of the electronic tools like data analysis software and computers that nurse use may also be used by the physicians in retrieving and evaluating of information about the same patient.

The Role of Nursing Informatics Specialist

With the advent of different electronic tools for nurses, the role of nurses in health care has been expanding. Many nurses are now working as specialists in various capacities and it is meant to achieve efficiency and better service delivery. It is on this premise that nursing informatics, as a crucial branch in the management and analysis of health data, provides nurses with a more enhanced opportunity to control and manage their information during delivery of services to the patients. A typical nursing informatics specialist will play a role in developing, implementing and evaluating health information systems and technology applications together with the processes used in the health center to assist nurses and health care providers with the management of their data. This, therefore, means that as the professional health care providers, nurses are no longer confined with dealing with patients in wards but can also play a role in evaluating the systems through which information flows from the physician to the patient and vice versa. This is important, given that the delivery of health information is central to the realization of the duties of a physician and thus nurses are strategically placed to use informatics as a tool in assisting in practice. They are also supposed to participate in identifying and analyzing relevant data that will be used in the care of patients. On many occasions, nursing informatics specialists will be called upon to use their informatics science skills to design and implement health information technology systems and apply it in resolving clinical and health care problems associated with administration. The dynamic work environment also means that nursing informatics specialist must be able to develop and implement policies and practices, which will ensure that the privacy, security, and confidentiality of information related to the patient is enhanced in their work environment.

The Positive Impact of Nursing Informatics to Health Industry

According to Bonnie & Abbie, the nursing profession has undergone positive changes since the introduction of technology tools in the management and evaluation of data in health care institutions. In particular, nursing informatics as a nursing specialty has continued to be an integral part in the health care sector through its provision of effective delivery of services and differentiation of roles in terms of selection, evaluation, and implementation of information technology tools in health care. Overall, it has also supported safe, cost-efficient and high-quality services to the patients. Moreover, nursing informatics has introduced a culture in health care where physicians and nurses are using current and accurate information from various sources and are able to easily share this information with their colleagues. Furthermore, through nursing informatics, nurses are able to participate in professional organizations and conferences with their like-minded colleagues and share interests on how to provide better services to their clients. This has improved the level of professionalism and service delivery among nurses, especially in the wake of a proliferation of patients who seek for medical attention in the health centers. Through nursing informatics systems, the government and the regulatory bodies in the health sector can track and analyze the performance of a nurse and recommend changes where the nurse might not be adhering to the rules. The field has also enabled the nurses to track medical records of their patients using data analysis tools and be able to provide necessary changes in medical prescriptions where patients do not show improvement in their health status even after medications have been administered.

The nursing informatics branch in nursing has also helped nurses in achieving higher rates of assessment of information and knowledge required in the provision of better services in health care and thus emphasizes on the importance of focusing on the patients’ needs. In addition, nurses are achieving high returns on accurate characterization, evaluation, and refining of clinical processes in their places of work. This is the departure from practices in the past where nurses were unable to deliver on the expectations of their client because they did not have relevant tools to assist them in characterizing and evaluating the clinical procedures. It is also now possible to develop and implement clinical support systems to help nurses in the giving high-quality services to their clients. Moreover, the percentage achieved in participation by nurses in issues such as procurement of equipment and customization of services through the use of informatics tools is higher in health care centers where technology tools have been adapted. More important is the fact that nurses are in control of what happens in their work environment and can, therefore, effectively manage the processes and procedures in accordance with their needs. Despite the challenges that are inherent in the use of technological tools in the provision of services in the health sector, it is evident that the benefits that accrue from the use of such tools outweigh the disadvantages. Thus, the nursing informatics has continued to impact the provision of services to patients and with continuous improvement and investment in the area, more benefits to medical practitioners and the nurses are on the way. The biggest gainers in the use of electronic tools in the management of health records are the patients who will not only receive accurate information about their health, but also the information will be delivered in an effective and efficient manner.

Conclusion

This paper provides a discussion of nursing informatics and how it has impacted the nursing profession. The paper has highlighted the positive and negative impacts of nursing informatics and the use of technology on the health sector. In particular, the paper highlights that nursing informatics is a relatively new area in the nursing profession. However, with increasing utilization of technology in all private and public sector, many health care institutions are embracing the use of technology tools to manage their information. It is now common to find nurses retrieving electronic information from their information management systems at their workplaces. The uses of electronic records are mainly aimed at improving the speed of service delivery and enhance the management and evaluation of patient records. Health information management systems have also received wide acceptance in the health industry because they enhance the safety and confidentiality of the information about patients. Computers have also become essential tools that are facilitating the analysis and administration of patient records in the health centers. However, the use of computers and other electronic tools in the management and evaluation of information in nursing has had an impact on the profession and the industry as the whole with the need to purchase expensive equipments and tools, which are used in the management of information. The hospital management also spends much on trying to train nurses who might not be conversant with the system. Moreover, the issue of safety and confidentiality has continued to elicit debate among stakeholders, especially, given that the level of information sharing among nurses is much higher than in the traditional system where only one nurse may have the access to the patients’ records. As a result, this has brought about the issue of ethics and legality on the storage of patients’ records on many occasions and regulatory authorities are still legislating laws to govern the level of sharing information amongst health care service providers.

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