The NHS faces unprecedented demand from patients and technology is seen as a key enabler to reduce inefficiencies and support patient safety improvements. But is enough being done to engage nurses? Asks Debbie Guy, a leading authority on the provision of out of hours care.
Technology is becoming more important to clinical practice, not just as a management reporting tool, but as an instrument to change the way we deliver care for the better. The government’s ambitions are clear – Simon Stevens, NHS England’s CEO is calling for technology to help “drive down variations in quality and safety of care” and reduce instances of avoidable patient harm in his Five Year Forward View.
In a subsequent report that focuses purely on modernising technology in the NHS, the National Information Board’s (NIB) Personalised Health and Care 2020 says that it is essential that care professionals and carers have access to all the data, information and knowledge they need in order to improve care delivery.
Frontline healthcare professionals also recognise the benefits that technology can offer. This was demonstrated with over 270 applications to NHS England’s Nursing Tech Fund 2 – of which 76 were successful in sharing the available £35 million. Interestingly a large proportion was awarded for electronic observations and mobile access projects.
Putting IT into practice
The ambitions above are very admirable, however, the reality is that achieving technology adoption on the wards is not always easy.
As a nurse with over twenty years of experience working on a ward, I have seen IT products introduced across hospitals which have been designed and implemented with little input from the clinical staff who actually use them. This has meant that clinical effectiveness is often lost and the system is not adopted wholeheartedly.
I am not a complete technophobe, but nor am I someone who spends every waking minute connected to their computer or laptop. If you asked me five or six years ago if I could see the benefit of technology for nurses, my answer would be slightly different to now.
The reason? At the time nurses in our trust did not actively use much technology, and if we did, the information would usually be stored in one location on PC-based systems. The idea of returning to the computer repeatedly during your shift was a huge problem when you have two PCs and lots of staff. Unfortunately, I had rarely found technology, as a nurse, particularly helpful to my duty of care. Healthcare technology, however, has come along way since then.
The emergence of the CNIO
As the roll out of clinical information and support systems continues to gather pace, the demand for nursing informatics expertise and leadership grows in tandem. As a result, a relatively new role is emerging here in the UK, which places nursing engagement at the heart of IT deployment, and ultimately supports the delivery of quality patient care and improved nursing practice.
The Chief Nursing Information Officer (CNIO) provides a crucial role in bridging the gap between IT professionals, clinicians and hospital management, ensuring that new technologies meet the needs of nurses in practice on the ward. The CNIO is the voice of calm and reason, with the experience and appetite to lead care transformation by restructuring an organisation’s culture and workflows, and having a deep understanding and appreciation of the barriers and pressures involved.
For nurses, technology can present a different way of working, requiring new skills and competencies – which are becoming increasingly important. This sentiment was echoed by Anne Cooper, NHS England’s clinical informatics advisor for nursing, who said earlier this year that thenurses’ use of mobile devices, online resources and electronic record systems was essential for improving care.
This is where the CNIO can add incredible value as someone with genuine nursing experience, who has a keen interest in technology and understands the problems of the trust. They have seen and experienced the problems on the ground because they have risen up through the nursing ranks and know exactly what difficulties nurses face on a daily basis. Not every trust at this stage has a CNIO but I believe they could be instrumental in our digital health revolution.
Technology at the point-of-care
I believe in giving the right tools to every hospital clinician so they can do their job effectively. For example, a desktop PC, as a device, is often not the right tool for the job. This is a common issue for both doctors and nurses as we do not sit behind the desk; we are on our feet, caring for patients or moving between wards.
Clinicians need the right tools to support their mobility, and that is why mobile technology, and a nursing informatics champion to support the transition to a mobile digitally-enhance environment, is absolutely what nurses need and ultimately what NHS hospitals need.
A recent Deloitte report on connected health confirms that in the UK mobile devices such as personal digital assistants (PDAs) are leading to an evolution in the way clinical data and information moves to and from the bedside to the patient record.
Indeed, the NIB report I mentioned earlier says the NHS needs to look into ways to present faster, more accurate diagnosis, and investigate opportunities to transform how remote channels can be used to deliver care.
For this to happen however, nursing teams need to be able to trust the technology they are going to use. It needs to be suitable for nurses’ requirements and easy-to-use. Technology that ticks the IT teams’ boxes, but does not comprehensively consider the needs of clinical staff is doomed for failure.
In these scenarios nursing informatics leaders are crucial in liaising with nurses and clinicians, as well as the organisation’s IT team, to smooth out any problems, iron out any difficulties and ensure that the IT product or system is intuitive and user-friendly before it is ready to be used on the ward.
Keep your eye out for part two of Debbie’s fantastic insight piece, which will explore how to overcome the challenges of resistance and unease in departments, championing the voice of the nursing informatics and much more.
Debbie Guy RGN had been a nurse in the NHS for over 20 years establishing a wealth of experience in emergency admissions nursing, project management and corporate operational management. Debbie is a leading authority on the provision of out of hours care, having been involved in the Hospital at Night programme since 2006 and was responsible for the award-winning transformation of the Hospital at Night process in Nottingham University Hospitals NHS Trust in 2010.