Suzi Birz, principal, HiQ Analytics, LLC
A new report shows that nurses are a key part of the latest trends in health information technology, a subject of growing interest to President Obama, health care leaders and patients across the country.
Vendome Group, LLC, New York, recently published Trends in Technologies for Nurses. Part of Vendome Group’s Healthcare Informatics Research Series, the survey report looks at clinical and administrative systems used by nurses in acute, ambulatory and specialty care facilities.
The online survey was completed in November 2007 by 252 hospital-based care providers and 112 outpatient services centers, including physician offices and ambulatory care centers. Nurses represented approximately one third of the hospital respondents and eight percent of the outpatient center respondents.
Nearly all the hospitals and more than three-quarters of the outpatient service centers reported that they support a nursing-centric technology or tool.
Core clinical application functions include automated alerts and reminders, clinical surveillance tools, computer-based practitioner order entry (CPOE) and cross-continuum patient record, electronic documentation and electronic medical records, e-prescribing, evidenced-based pathways, and picture archiving and communication systems (PACS).
Examining the data across the reporting hospitals, more than half of all clinical information systems users were identified as nurses. Electronic documentation, electronic medical/health records, and PACS are the most common applications available to nurses.
“Nursing documentation was found to have the highest use among nurses,” said Charlene Marietti, director of corporate editorial initiatives for Vendome Group. “Nurses are primarily responsible for the ongoing documentation of care, so all paper-based functions have to shift to electronic formats, with patient assessment being the focus now.”
“Almost equal in use with patient assessment is medication administration,” added Marietti. “Ensuring patient safety is important and nurses have a goal of improving the loop of medication delivery.”
The survey found that nurses use identification verification and tracking technologies including electronic medication administration and management (eMAR) and automated medication distribution cabinets.
In the hospital environment, the survey found that most users are able to access pharmacy, laboratory or radiology.
When surveying organizations that require nurses to use clinical electronic documentation, training, education, and resistance to adoption were cited as the greatest barriers during implementation.
In addition to clinical information systems, the report examined use of patient management systems and other technologies including communications and medical devices. The survey found that document imaging and patient and staff scheduling systems are frequently used by nurses.
“Scheduling tests and ensuring all patient information is available make document imaging and scheduling systems well-utilized by nurses,” explained Marietti. “In the ambulatory setting, nurses often play a significant role in scheduling and reimbursement.”
The survey found that organization size and location play a role in whether nurses have access to technologies. The opportunity for nurses to have technology tools available to support daily work and reporting requirements increases in larger hospitals, hospitals in urban areas, hospitals that are part of larger networks and physician offices where four or more physicians are employed.
Nurses are being recognized as critical to the successful implementation of technology in clinical settings. Of the reporting organizations in the survey, more than half have nurse informaticists. Nurse informaticists are, by ANA’s definition, specialists who integrate nursing science, computer science and information science to manage and communicate data, information and knowledge in nursing practice.
“In the hospital setting, two-thirds of the reporting facilities have at least one nurse informaticist,” added Marietti.
“The most positive findings were confirming the acceptance by nurses of technology and the number of facilities with nurse informaticists on staff,” summarized Marietti.
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