It was during the Stone Age (2.5million years ago) that mankind began to separate themselves from all other species and creatures and rise to the top of the food chain and essentially rule the earth (Violatti, 2014). The cave man struggled to find food and shelter for his people and too a much larger and simpler sense, fought to survive the vast dangers of his time. What was it that allowed these people to not only survive but thrive in their world? Innovations of the technology of the time; the discovery and use of fire, clothing, and weapons all brought mankind out from the cave and into a new world.
It is now the year 2020 A.D. and as healthcare workers we are coming into a new world and new innovations of technology for our time. And just as the leaders of caves needed to teach the younger generations how to make fire, ambush their prey, and form and make their weapons and tools in order to guarantee the survival of their tribe; nurse leaders too, must teach the younger generations how to properly work with various information technologies, computer systems, and digital information.
My name is William, and I have been working in the cave of healthcare for nearly twelve years and I have been a nurse for the past eight of those twelve years. I have worked in medical surgical departments and in a Cardiac Cath Lab; however, for this presentation I want to focus on my time spent as a student and new nurse preceptor. Over the years I have had the pleasure and frustration to work and train a significant amount of people from various schools, universities, and programs; while some had considerably stronger skills and intelligence than others they all had one thing in common. A lack of understanding for information technology; clearly informatics was and is a foreign subject to many of our local nurse graduates and nurses.
Making Digital Fire
During the training and orientation period, electronic charting and data entry acts as the most cumbersome obstacle for students and new nurses, and so as the advanced-practice informatics nurse one has to consider the question, “why is it that these people do not know how to make digital fire?”
Lee, Carson, Clarke, Yang, and Nam (2019) claim that nursing students struggle with the difficulties of utilizing technology both in learning and in practice. The writers report that there are multiple barriers that prevent nursing students from being comfortable and proficient in use of information technology; lack of opportunity to gain clinical information and data with technology, insufficient support from professors and institutions, and a lack of continuity with in class teaching and clinical teaching. It has been voiced my many of those that I have precepted that what is being taught in regards to charting and data entry in class versus what is actually being done in the “real world of nursing” are quite different.
Essentially, the mindset that is being taught to our nursing students in regards to charting, data entry, and information gathering is that of the early 20th century. Hand-written charts and paper medication administration records while almost becoming extinct are still the standard of learning for many nursing students. This philosophy of education metaphorically equates to telling our students that you will have learn how to make your weapons and tools out of stone and bone in regards to information. However, in all reality today’s information technology is more like a machine gun instead of a handmade spear or axe.
The Tools of Yesterday
The Tools of Today
Silva, Ângelo, Santos, Lumini, and Martins (2019) write that due to the ever-changing and evolving healthcare system and information technology innovations it is imperative that these technologies become an intricate part of the teaching-learning process for nursing students. Chung and Cho (2017) take this belief one step further by stating the need to implement academic Electronic Health Records for both educator and student use. Chung and Cho (2017) believe that an academic Electronic Health Record will not only help students to become comfortable with the practical use of the technology but also students can become familiar with the indirect uses and benefits of information technology; such as, meaningful use, data capture and analysis, and improved patient care and outcomes. With the lack of technology in nursing schools and programs there is a clear and evident gap of practice with nurse graduates, and the implementation of technology has been either absent or slow for many nursing curriculums (Dickens, 2017). However, by initiating student use and exposure to information technology well before beginning their new careers, students can start day one as nurses that are comfortable and competent in the use of technology.
Using the Digital Axe
As stated before, the survival of the cave dwelling tribe was completely dependent upon leaders teaching the younger generation. And as such, nursing leaders should seek to partner with local nursing education institutes to introduce informatics and information technology to nursing students. Healthcare facilities already employ recruitment liaisons that work with surrounding universities, schools, and programs; the employment of an informatics education liaison would not a far-fetched idea. However, the introduction of informatics education is completely dependent upon the in professors and curriculum designers.
Healthcare leaders and administrators can certainly initiate informatics teaching for new employees during the initial orientation period. In my opinion, this is pivotal to establish a standard for nursing charting, data entry, and use of the technology. So often new nurses are exposed to a number of differing ways to chart and input information that a lack of consistency brews throughout the department. This inconsistency leads to staff confusion and frustration, input errors, and insufficient data capture and analysis; therefore, by teaching the newly hired staff the appropriate ways of using the technology these inconsistencies can be remedied before they occur. As the new nurses join their departments the informatics education liaison can not only serve as a resource but also serve to provide follow-up and updated education regarding the technology.
The implications of providing facilities with such a resource as an informatics education liaison would prove to be most beneficial. Seeing as many facilities are seeking to improve meaningful use through use of Electronic Health Records and are growing more dependent upon Medicare and Medicaid reimbursements programs, then improving many aspects covered in this presentation would greatly serve as valuable and advantageous (Centers for Disease Control and Prevention, 2019).
Come Out of the Caves
Those who serve as leaders are responsible for putting the next generations of nurses in a better position than we currently find ourselves; this mindset is applicable to the training of informatics and information technology. The world at the time of the Stone Age was quickly changing; the landscape, the climate, and the dangers were unrecognizable to many. Much like the Stone Age, the world of healthcare is quickly changing; the politics, the patients, and the technology are almost unrecognizable to many. And just as the cave man adapted his way of living, we too must adapt. The innovations of fire, clothing, weapons and tools are what allowed the cave dwellers to not only survive their world but conquer and thrive. Nurses have the innovative tools of our time to endure, survive, and thrive in the world of healthcare. The question we must ask ourselves, “Are we ready to come out of the caves?”
References
Centers for Disease Control and Prevention (2019). Public health and promoting interoperability programs (formerly, known as electronic health records meaningful use). Retrieved from https://www.cdc.gov/ehrmeaningfuluse/introduction.html
Chung, J. & Cho, I. (2017). The need for academic electronic health record systems in nurse education. Nurse Education Today, 54, 83-88. DOI: https://doi.org/10.1016/j.nedt.2017.04.018
Dickens, M. (2017). Exploration of the use of mobile technology in an ADN program. Kentucky Nurse, 65(2), 14-14. ISSN: 0742-8367
Lee, J.J., Carson, M.N., Clarke, C.L., Yang, S.C., & Nam, S.J. (2019). Nursing students' learning dynamics with clinical information and communication technology: a constructive grounded theory approach. Nurse Education Today, 73, 41-47. DOI: https://doi.org/10.1016/j.nedt.2018.11.007
Silva, I., Ângelo, J., Santos,F., Lumini, M.J., & Martins, T. (2019). Satisfaction and usability of an information and communictions technology in nursing education: a pilot study. Revista de Enfermagem Referência, 4(21), 143-150. DOI: https://doi.org/10.12707/RIV19013
Violatti, C. (2014). Stone age. Retrieved from https://www.ancient.eu/Stone_Age/
Hi William,
ReplyDeleteVery creative blog! I discussed something similar to this topic in my own blog. I don't understand how my own personal technology, like my smart phone, seems to be so much more convenient and useful than the technology we use at work. Some of that could be contributed to the lack of preparation for the use of advanced technology, but I also think some of it can be contributed to the hesitancy often displayed when making decisions to incorporate new technology in healthcare, particularly in the outpatient setting. Thanks for such an insightful post. Your ideas for new employee education and an informatics liaison are great.
William, great blog post! I was not very familiar with informatics prior to this class. I thing your idea of nurse preceptors being the ones who spread the knowledge on this subject is ideal. It would be the best way to capture the most people and disseminate the most information. Having a specific informatics educator would not only bridge the current gap in technology and healthcare but would allow for better technology which in turn leads to better patient outcomes. I am not sure that there would currently be a lot of buy in on a paid educator but I believe that after the initial information is put out there and the senior leadership teams can see the long term benefits they would be on board.
ReplyDeleteHey William,
ReplyDeleteI thought this was a great blog post! Very creative, engaging, and informative. I think this is such an important topic and I completely agree that we are behind the times in nursing education when it comes to healthcare information technology. Chung and Cho (2017) talk about how important it is to not only teach nursing students about the technical and functional side of technology like electronic medical records, but also to understand the value it brings to patient safety. I think we need to educate new nurses, and reemphasize with experienced nurses appropriate and needed nursing documentation. One of the blessings and curses of electronic medical records is that it gives you an opportunity to document literally everything you could ever want to document on a patient, and it makes it all easily accessible. Couple that with a healthcare system plagued with lawyers chomping at the bit, and it creates a culture where nurses are taught "if you didn't document it, it never happened" and leads to a feeling of needing to over-document. This is a large part of what keeps nurses tied behind the computer for so much of their shift. There is a great opportunity to improve proper education of how to utilize electronic medical records, and to understand what they are meant to do, and what they are not meant to do. Nurses need to understand technology, how to properly use it, and how data supports clinical decision making. Without it, nurses are struggling to utilize electronic medical records in an efficient way creating frustration and potentially ineffective and inefficient habits.
Reference:
Chung, J., & Cho, I. (2017). The need for academic electronic health record systems in nurse education. Nurse Education Today, 54, 83-83.