A key message of the Institute of Medicine’s 2010 Future of Nursing report is that nurses ought to be “full partners, with physicians and other health professionals, in redesigning health care in the United States.”
When forging such partnerships with “other health professionals,” don’t make the mistake of neglecting your colleagues in the information technology (IT) department, nurse executive and techie, Candace Smith, MPA, RN, NEA-BC, writes in the September issue of Nursing Management.
“With technology and innovation playing a vital role in patient care, nursing and IT leaders must collaborate on decisions that impact clinical workflow, timeliness of care, and patient experience,” explains Smith, senior vice president and chief nursing officer at Voalte, a Sarasota, FL-headquartered company that specializes in improving hospital communication with smartphones.
If nurse leaders don’t have a say in identifying, choosing and evaluating the technology their staff will use, they run the risk of sticking their frontline nurses with inefficient systems that detract from patient care, add to their workload, and generate unnecessary confusion in communication with patients and other healthcare providers.
Here are four popular tech initiatives that, according to Smith, benefit from a ramped up partnership between nursing and IT leaders:
“I was speaking to a neurologist recently, and he shared that there are five different places in the EMR where he can document the same patient information,” Smith recalls. “Although he had clearly articulated in the notes that a patient could be started on a certain medication, the next day he received a call from the nurse asking whether the patient should receive the medication. She hadn’t seen the note simply because she hadn’t looked at that particular field or location.”
Stories like this aren’t unique, but they paint a clear picture that with all the efficiencies EMRs promise in theory, they aren’t always at their most ideal “out of the box.” Listen to your bedside nurses, Smith advises, and allow them a say in suggesting modifications that will improve the EMR experience in the workplace.
“Nursing leaders need to value this input from people working on the front line to get the full benefits of the technology,” she writes.
For hospitals looking to replace outdated modes of mobile communication (think walkie-talkies, pagers and legacy phones) with smartphones, IT expertise mingled with nurse input will help ensure the technology is a help—and not a hindrance—at the point of care.
Smith shares the story of one West Coast hospital that, through a strong nursing and IT team partnership, is implementing a notification system that transfers nurse call alerts, physiologic monitor alarms, bed alarms, EMR alerts, and ventilator alarms to the nurses’ smartphones for on-the-spot notifications.
“This is yet another way to streamline care,” she observes, “and provide excellence in patient care, quality, and safety.”
Nuisance alarms are an annoyance as well as a potential danger when clinicians confuse them with important alerts in need of immediate attention. To reduce alarm fatigue among nurses—which The Joint Commission has identified as a national patient safety goal—nursing leaders should work with biomedical engineering/IT staff to analyze data prompting the alarms.
“This information will point to what’s driving the alarms and what you can do from a clinical practice perspective to begin reducing nuisance alarms,” Smith advises.
As the primary professionals impacted by the technology, nurses should be involved in any project aimed at changing or upgrading a hospital’s nurse call system. It may sound logical, but that’s not always the case in the real world. Smith recently visited a hospital where nurses were left out of the process. When during an alarm and alert committee meeting the nursing team questioned the biomedical engineering staff on how the new system was expected to impact their routines, they received no solid answers.
“With nurse call systems being so crucial to responsive patient care, it’s vital that nursing leaders engage with their IT colleagues to set up nurses for success,” Smith writes.
Even after implementation of a new system, it’s a good idea to host some interprofessional focus groups from multiple units so both nursing leadership and the IT team can get a handle on what’s working and where there’s room for improvement.
Plus here is a fifth that is absolutely essential for nurse leaders to involve the staff.
Bringing evidence-based practice to the bedside for just in time clinical decision support is critical in today's complex world. Providing the latest clinical and procedural information at the time of patient care enables clinicians to competently assess and implement plans of care at the bedside, without wasting valuable time leaving the patient's side to track down information or using out of date information in their care of the patient. The greatest benefits of EBP clinical decision support is when it is imbedded in the EMR-based clinical workflow.
In the healthcare workplace, technology decisions shouldn’t be made in a vacuum. With proper input and collaboration, nurses and IT professionals can work together to ensure technology is used to its fullest capacity to better the hospital experience for both patients and providers.
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