THE INCLUSION OF NURSES IN THE SYSTEMS DEVELOPMENT LIFE CYCLE NURS 6051

THE INCLUSION OF NURSES IN THE SYSTEMS DEVELOPMENT LIFE CYCLE NURS 6051

THE INCLUSION OF NURSES IN THE SYSTEMS DEVELOPMENT LIFE CYCLE NURS 6051

Nursing data, when properly collected and interpreted, can be used to improve the productivity, efficiency, performance, efficacy, cost, and value of nursing care (Mosier et al., 2018). With the surge in health technologies over the past decades, the creation of knowledge through digital data collection and information processing has become an important focus within the field of nursing informatics (NI). This discussion post will describe technology and informatics-related interactions at this author’s current place of employment and in a past circumstance. A suggestion of how nursing informatics roles could be improved and expanded on is included.

Reflections

The author of this post works in a large urban women’s health clinic where both obstetric and gynecological services are provided. There are 11 registered nurses (RNs) on the staff roster, with six nurses on staff at the clinic each day. The clinic and the umbrella medical group to which this clinic belongs do not have a NI team or individual. However, the lead clinic RN at the women’s clinic is an Epic superuser and has expressed her interest in someday pursuing a specialized certification in NI. As an Epic superuser, this nurse fulfills some of the roles of a NI, but lacks the formal training and education a certified nurse informaticist possesses (Nagle et al., 2017). Staff nurses and other medical personnel can ask this Epic superuser for help navigating and accessing data within the charting system. This superuser can even tackle smaller data management projects like creating patient tracking lists within the electronic health record. Minor issues can be addressed by the superuser during the day, while large systems concerns are generally addressed at nursing staff meetings. To be clear, there is not a formal process or policy in place for these interactions.

During a clinical rotation at the Children’s Hospital in Denver, Colorado, the author of this post vividly remembers a positive encounter with the hospital’s nurse informaticist. There was a patient with a gastrostomy-jejunostomy, where continuous tube feedings (TFs) ran through the jejunum portion; the gastric hub was not in use and scheduled for regular water flushes. The charting system had a simple tube feeding section, but it did not break the TFs into different sections for appropriate documentation of the various interventions being administered through each portion. Luckily for the floor nurse, the nurse informaticist was doing rounds on the unit that day, so the nurse was able to discuss her concerns with the informaticist directly. The informaticist listened to the floor nurse’s concerns, and then the two nurses together investigated the charting system to see what potential changes could be made. The nurse manager was also briefly pulled over to be updated on the situation and offer input. While this author does not know the final outcome, it was inspiring to see a team of clinical experts, nurse leaders, and technology experts come together to help improve nursing workflow and patient safety.

Suggestions for the Future

The NI role is important because it combines nursing and technology science to improve patient care, safety, and workflow (McGonigle & Mastrian, 2018). With only 11 RNs on staff at the clinic, creating a full-time NI position specifically for the women’s clinic may not be reasonable. However, the medical group, which embodies half a dozen outpatient clinics, could create a NI position to severe all the clinics collectively. This way, nursing technology processes that prove successful in one clinic could be adopted and amended to serve the other clinics as needed.

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In addition to adding a nurse informaticist to the medical group roster, another suggestion to improve staff interactions with nursing informaticists or technology experts is through nurse leadership. According to Mosier et al. (2018), nurse leaders can positively impact the integration of clinical experts, technology experts, informaticists when tackling nursing informatics projects within hospital systems. Executive nurse leadership helps to organize, design, and influence nursing informatics solutions. This study highlights the importance of upper-level nurse leadership to oversee and improve NI interactions. Leadership is crucial; staff with their own workloads cannot always be expected to coordinate NI projects. For example, in the women’s clinic, the nursing manager or supervisor could help create a defined platform for which informaticists and nursing staff can interact. Perhaps a nurse informaticist could make rounds at the clinic on pre-scheduled days, or nurses from the various clinics can be invited to spend time at the informatics office to facilitate collaboration.

Impact of Continued Nursing Informatics and Technology Development

The continued emergence of new technologies within healthcare will have an immense impact on professional interactions. For the purpose of this discussion, professional interactions are interactions between colleagues or interactions between health staff and their patients. In the future, electronic health systems will become more data intensive, but also more user-friendly. Some experts hypothesize that eventually, clinicians will be able to plug patient data into health technology systems, then those systems will produce the most likely diagnoses and patient interventions (Laurate Education, 2018).

While these systems will not replace the role of doctors and nurses, they will cause the clinician to spend more time using technology. As a result, this author foresees two important outcomes. First, clinicians will need to become more tech-savvy, and nursing informatics will play a more prominent role in health facilities. Staff interactions with NI specialists will become more commonplace, and nurse informaticists will need to develop and hone project management skills to successfully guide this transition (Sipes, 2016). At hospitals, a nurse informaticist might be on-call around the clock for support and problem-solving. A second impact that the emergence of new technologies may have on professional interactions is related to the art of caring. The art of caring refers to a caregiver’s intentional promotion of recovery and wellness and recognition of inherent personal value and feelings of connectedness (McGonigle & Mastrian, 2018, Chapter 25). Nursing’s core values are rooted in caring for the health and wellbeing of others. Nursing care must not become dehumanized; it is essential personal interactions such as touch, intentional listening, therapeutic communication, and mindfulness are not removed from this profession. More training may be needed to help caregivers balance the ever-evolving use of technology at the bedside without losing the personal touches and expressions of connectedness that are the building blocks of this profession.

References

Laureate Education (Producer). (2018). Health informatics and population health: Trends in population health [Video file]. Walden University Blackboard Nurs6051. https://class.content.laureate.net/f5055760e0020de1c3cc4b123b669695.html#section_container_20

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions: The role of executive leadership. The Journal of Nursing Administration, 49(11), 543-548. https://doi.org/10.1097/NNA.0000000000000815.

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. Forecasting Competencies for Nurses in the Future of Connected Health, 232, 212–221. https://doi.org/10.3233/978-1-61499-738-2-212

Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252-256. https://doi.org/0.3233/978-1-61499-658-3-252

 

Thank you for your post. I find it interesting that the clinic or umbrella medical group that you for work does not have a nurse informatics position. I can’t help but to think that smaller clinics and medical groups think it’s not essential to have a NI position. Informatics has become a large part of patient care over the last couple of years and will continue to grow and an essential part of providing quality patient care. To help with the knowledge barrier of informatics within your place of work, the nurse leader could get certified in nursing informatics or continue their education by taking nursing informatics classes. Nurse leadership allows there to be understanding of informatics because of their broad understanding and oversight of nursing care (Mosier, Roberts, & Englebright, 2019). The staff nurses can look up to the nurse leader for questions and concerns related to informatics. The nurse is a knowledge worker because they generate information and knowledge into a product (McGonigle & Mastrian, 2017). Even though there isn’t a nurse informaticists specifically there to work in informatics, everyone works together as knowledge workers to help improve patient care.

 

References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

 

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

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