DRNE: Bridging the Gap Between Nurses and Information Technology Specialists

Abstract

With the implementation of electronic health records (EHR) the amount of information collected has skyrocketed. Now that standardized nursing taxonomies are being adopted, such as the Critical Care Classification System (CCC), the computer skills of nurses in the new digital world should be addressed. Nurses must translate the digital capture of live data from the EHR into an increase in patient safety, patient outcomes, and nursing workflow. Conveying the importance of how the new streamlined process of digital data capture will simplify the patient continuum of care to nurses is critical. Consequently, with the implementation of electronic health records (EHRs) now in place, nurses need more clinical and technical support. In 2013, four hospitals surveyed their nurses about their experiences after their EHRs went live. Responses varied with one resounding theme best summarized by this statement, “You can tell that a nurse didn’t design this program!” (personal communication, 2013). The lack of IT support and the lack of communication from the IT department when problems are/are not resolved also emerged as common themes. For instance, submitting a “ticket” about problems which cannot be tracked results in an increased level of frustration for medical staff. “Every ticket gets ignored or the response is the issue has been solved when it hasn’t; this has been going on for months,” is just another example of the nurses’ frustration (personal communication, 2013). The problem addressed in this research study is that there is not a streamlined and effective mechanism in place to track the status of a ticket submitted to IT within the hospital setting. This failure affects patient outcomes/safety and causes frustration between the IT staff, nurses, and other hospital staff. Goals of this research include the proposal of a new communication process/workflow between IT staff and nurses to alleviate frustration, improve communication, and provide nurses with more resources when charting in the EHR. Assess the Need for Change in Practice The Internet has revolutionized healthcare. New technologies, new hardware/software programs, and new mobile applications are creating opportunities in healthcare that were not possible ten years ago. With the implementation of more demanding technology in the healthcare environment, nurses are challenged by incorporating technology within every aspect of the nursing process. During the assessment and diagnostic phases, nurses are required to gather, assimilate, think critically, and interpret the data, form a diagnosis and chart it flawlessly in the EHR. In the planning and implementation phase of the nursing process, nurses rely on an interdisciplinary approach for patient care. However, are nurses confident that all members of the medical team effectively use the technology in the work environment? Ultimately, does the patient trust their medical team accessing their personal information stored via an EHR? During the evaluation phase nurses interact with their patients using various communication methods hosted on the hospital’s server, such as responding to patient’s questions in the emails, scheduling appointments, and periodically updating patient information in the EHR, which then can be transmitted to an app on the hospital’s mobile phone or tablet. Therefore, the digital nursing experience is quickly becoming an important aspect of the nursing process, which has a direct effect on patient care. Because of this the need for change in the clinical setting is centered on the nurse’s ability to develop the necessary computer skills in order to be successful in this digital age of healthcare. Nurses need to not only understand what information is important but where to chart, locate, and update it within EHRs. Hospitals should include more educational training and IT support not only when a new EHR is being introduced but following the implementation as well. The digital/technical requirements for understanding how to maneuver through new EHRs has been addressed by several professional organizations including Technology Informatics Guiding Education Reform Initiative (TIGER), the American Nursing Informatics Association (ANIA), Healthcare Research and Quality (ARHQ), the Institute of Medicine (IOM), and Healthcare Level 7 (HL7). Quality measures and standards of practice used in EHRs created by these organizations are discussed below.