Impact and Importance of Informatics in Nursing
The issue that I have observed during my Practicum Experience was an unplanned downtime of the EHR system that lasted for an hour. As a result, the healthcare staff suddenly lost access to patients’ clinical information. When the downtime occurred, the staff was notified about the system status and the plan of action. However, it turned out that the personnel was accustomed to using EHR, so they could not easily locate the necessary paper forms, and the existing forms were outdated. In an hour, the access was restored by restarting the system and using the last reliable backup.
The EHR system is a crucial healthcare technology since it contains systematized patients’ clinical data. Unplanned downtime is the major issue with the EHR system, threatening patient safety (Walsh et al., 2020). This is because healthcare professionals nowadays are overly reliant on the electronic system, and some of them have never dealt with paper forms (Dave et al., 2020). According to Sittig et al. (2018), it is the joint responsibility of EHR developers, EHR users, and government regulators to ensure the safety of this technology.
The problem of the EHR downtime was handled consistently with scholarly evidence in terms of communication. When the problem occurs, the leadership should inform the staff about the situation and provide directives, which was performed during the observed downtime (Dave et al., 2020). Scholars also note that contingency planning and staff education are necessary to mitigate the impact of EHR downtime (Walsh et al., 2020). In this regard, the observed actions were inconsistent with scientific evidence since the personnel seemed to lack training, and the organization’s contingency plan was not updated. Therefore, the matter could be approached differently by reviewing the organization’s contingency plan, which should include updating paper forms and ensuring they can be easily located. It is also necessary to educate the staff about keeping track of patient data without using EHR.
Integrating Health Information Technology Safety into Nursing Informatics
The issue I observed during my Practicum Experience involved a patient identification error. There were two patients of similar age and with similar head injuries who presented to the emergency department at the same time. However, patient 1 survived a road accident, while patient 2 was found unconscious near a bar. A CT of the head and face was ordered for both of them. For patient 1, a CT of the abdomen and pelvis also had to be performed. However, the CTs ordered for patient 1 were performed on patient 2. When the results were received, the healthcare team discovered the inconsistencies with physical exams and performed the additional CT for patient 1, and the CT results were correctly relabeled.
The observed issue refers to health information technology-related wrong-patient errors. According to Kim et al. (2020), these mistakes lead to delay in care because there is a need for a retest or reimage. Reviewing information is crucial for noticing such errors before they reach the patient (Kim et al., 2020). In addition, nurse informatics specialists should analyze incident reports and evaluate whether technology can contribute to the reported errors and near misses (Borycki et al., 2017). Health information technology such as scanners and barcodes should be used for correct patient identification and data entry (Yusof & Sahroni, 2018).
In the observed issue, the healthcare team’s reviewing the CT results was consistent with scholarly evidence since it has helped to identify the error. However, no actions were taken to avoid such incidents in the future, which is inconsistent with best practices. To approach the problem differently, the organization could adopt technology such as scanners and patient barcodes. These barcodes would be scanned each time before a CT, thus reducing the risk of patient identification errors. The staff should also be trained to use the technology consistently and correctly to further improve patient safety.
Recruitment and Retention of Nurses in Health Care
The recruitment and retention issue that I observed in my practice was the high nurses’ workload. Nurses often worked overtime and attended to a large number of patients per day. For example, I observed that one nurse was assigned to six patients during her working shift. Furthermore, due to the high workload, healthcare assistants were sometimes asked to perform registered nurses’ duties. In addition to caring for patients, nurses had to perform much paperwork.
Nursing informatics is important for achieving the optimal levels of staffing and workload. According to Paulsen (2018), data are key for identifying the staffing levels, and nursing informatics provides the necessary tools for collecting and getting access to these data. Fathian et al. (2019) also note that health information technology is widely used for managing human resources, namely, measuring workload and unit staffing and classifying patients. There are various workload management tools that can help healthcare organizations manage the nursing staff, such as nursing hours of care per day and nurse-to-patient ratios (Doleman & Duffield, 2021). There are also commercial software packages that determine the required number of hours based on patient data.
In the observed situation, nurses experienced a high workload, but no information system seemed to be used in the setting, which is inconsistent with scholarly evidence. To approach the matter differently, the organization should implement a health information system to measure nursing workload. Nurse managers have to advocate for installing a uniform information system that would help to manage workload and improve patient care (Doleman & Duffield, 2021). The data about nurses’ completed tasks should be collected regularly, and the staff should be educated on how to use the system. The information obtained through such technology would help managers plan workload more effectively.
Dave, K., Boorman, R. J., & Walker, R. M. (2020). Management of a critical downtime event involving integrated electronic health record. Collegian, 27(5), 542-552.
Sittig, D. F., Belmont, E., & Singh, H. (2018). Improving the safety of health information technology requires shared responsibility: It is time we all step up. Healthcare, 6(1), 7-12.
Walsh, J. M., Borycki, E. M., & Kushniruk, A. W. (2020). Effects of electronic medical record downtime on patient safety, downtime mitigation, and downtime plans. International Journal of Extreme Automation and Connectivity in Healthcare, 2(1), 161-186.
Borycki, E. M., Cummings, E., Kushniruk, A. W., & Saranto, K. (2017). Integrating health information technology safety into nursing informatics competencies. Studies in Health Technology and Informatics, 232, 222-228.
Kim, T., Howe, J., Franklin, E., Krevat, S., Jones, R., Adams, K., Fong, A., Oaks, J., & Ratwani, R. M. (2020). Health information technology–related wrong-patient errors: Context is critical. Patient Safety, 2(4), 40-57.
Yusof, M., & Sahroni, M. N. (2018). Investigating health information systems-induced errors. International Journal of Health Care Quality Assurance, 31(8), pp. 1014-1029.
Doleman, G., & Duffield, C. (2021). Administrative applications. In P. Hussey & M. A. Kennedy (Eds.), Introduction to nursing informatics (5th ed., pp. 233-266). Springer.
Fathian, A., Emami, H., Moghaddasi, H., Kazemi, A., & Rabiei, R. (2019). Features of nursing management information systems: A systematic review. Biomedical Journal of Scientific & Technical Research, 21(2), 15773-15781.
Paulsen, R. A. (2018). Taking nurse staffing research to the unit level. Nursing management, 49(7), 42-48.