Much of healthcare improvement via technology initiatives address gaining physician by-in (Reinertsen, 2005) and does not adequately address engaging nurses, despite the fact that nurses serve as the front-line care givers and are a primary user group (Wiley-Patton and Malloy, 2004). However, the tide is changing and visibility of nurses as information gatherers and processors in the patient care process is increasing (Romano, 2006). Nurses perform the majority of the data oriented tasks involved in patient care and would benefit most from having access to information at the point of care (Bove, 2006). RADM Romano, Chief Professional Officer of Nursing and advisor to the US Surgeon General concerning public health, recently addressed the American Informatics Nursing Informatics Association and stated “This is the year of the nurse. The technologies that have the means to improve the efficiencies in patient care are in the hands of the nurses.” Nurses need to embrace technology in everyday work or continue suffering the consequences of antiquated methods of computing that take us away from where we work – at the point of care (Abbott, 2006).
TopIntroduction
Much of healthcare improvement via technology initiatives addresses gaining physician by-in (Reinertsen, Pugh & Bisognano, 2005) and does not adequately address engaging nurses, despite the fact that nurses serve as the front-line caregivers and are a primary user group (Wiley-Patton & Malloy, 2004). However, the tide is changing, and visibility of nurses as information gatherers and processors in the patient care process is increasing (Romano, 2006). Nurses perform the majority of the data-oriented tasks involved in patient care and would benefit most from having access to information at the point of care (Bove, 2006). RADM Romano, Chief Professional Officer of Nursing and advisor to the U.S. Surgeon General concerning public health, recently addressed the American Informatics Nursing Informatics Association and stated, “This is the year of the nurse. The technologies that have the means to improve the efficiencies in patient care are in the hands of the nurses.” Nurses need to embrace technology in everyday work or continue suffering the consequences of antiquated methods of computing that take us away from where we work—at the point of care (Abbott, 2006).
Healthcare can benefit greatly from use of a diverse set of technologies as facilitators of change to improve quality and safety of patient care by decreasing errors made because of the lack of faster, more comprehensive, and more accessible patient documentation at the point of care (IOM, 2000). Healthcare institutions abroad share similar sentiments according to international healthcare reports by the International Council of Nurses (Buchan & Calman, 2004). In light of these concerns and a severe U.S. nursing shortage (i.e., an estimated 400,000 shortage by 2020) (Bass, 2002), institutions are beginning to consider employing point-of-care IT as a means to promote patient safety, decrease medical errors, and improve working conditions for overtaxed nurses (TelecomWeb, 2005). This chapter provides an overview of nursing reform and novel ubiquitous computing integrating voice, hands-free, and mobile devices being researched or used to make nursing more efficient and promote the following:
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A decrease in laborious documentation aspects (i.e., decrease problems with access to information at the point of care, written errors or legibility issues precluding comprehension of medical regimens).
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An increase in recruitment and retention rates.
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Improvement in communication in which nurses are required to consolidate and process information during care.
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Promotion of involvement in systems analysis and design of information systems to increase the likelihood of technology acceptance.
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Baseline and continuing education in both professional training and on-the-job training to allay technology aversion and build computer self-efficacy.
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Development of standards for electronic documentation of patient interaction and processes for nursing that can be codified.
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Identification of role changes in the nursing community because of the use of information systems and technologies.
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More rigorous research concerning information research in the nursing community.
TopBackground
This chapter provides an overview of tactics to reform nursing sponsored by leading nursing healthcare information systems research in professional organizations such as the American Nurses Informatics Association (ANIA), Association of Medical Informatics (AMIA), and the International Council on Nursing (ICN).