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.
In the second instalment of a two-part series, Debbie talks about how to overcome the challenges of resistance and unease in departments, championing the voice of the nursing informatics and much more.
Experience is essential
As part of a team in an IT company, I have had some great experiences of working with nursing informatics leaders. Julia Ball, assistant director of nursing at University Hospitals of Leicester NHS Trust passionately believes in clinical engagement and the importance of involving frontline staff in IT projects right from the very beginning, right through to the final sign off.
During the implementation of an e-observations project, the trust appointed staff ‘champions’. Nursing and medical teams on some wards ‘buddied up’ with those champions to pass on knowledge and experience of deploying a new system – producing strong advocacy for the technology and therefore an effective, engaged, and rapid roll out across other parts of the hospital.
Nursing informatics leaders help to translate and articulate the new IT systems’ risks and benefits to clinical staff, whilst sharing clinical challenges and issues to the organisation’s IT department and effectively managing partnerships at all levels to ensure nursing goals are communicated and met.
Overcoming challenges of resistance and unease
Nursing informatics leaders face many challenges – including cultural ones. Nurses are working longer in their careers and are used to certain ways of working. There can be resistance to new systems and technology, with many staff anxious of change. When I was a full-time practising nurse, I would perform my day-to-day tasks without once using a digital system so I can relate to nurses’ concerns when asked to use new technology.
The NHS is undergoing a huge cultural change but it cannot leave any of its staff members behind; NHS managers must be aware of the concerns, especially of the more conservative nurses, and educate and train them accordingly. And that is crucially, where the nursing informatics leaders can support; they can ensure all nursing staff are equipped with the training and expertise to carry out their duties aided with technology.
Championing the voice of the nursing informatics
The varying roles of nursing leaders that advocate informatics are a real asset to the NHS. I would however like to see the role of a CNIO promoted and appointed in as many trusts as possible.
Crucially, the CNIO is not just another bureaucratic figure. They will work in collaboration with the Chief Medical Information Officer (CMIO) guaranteeing that the voices of nursing and clinical staff are infused in the IT decision-making process. After all, nurses are key users of patient data and are responsible for documenting large amounts of patient information.
The benefits of managing real time data effectively are significant for patient safety – from the ability to reduce avoidable harm by identifying deteriorating patients early, to ensuring that there is sufficient staff resource to give each patient the attention they need. It seems logical for nursing staff to have an informatics champion who is responsible for defining and implementing their organisation’s strategy for IT adoption and implementation, ensuring patient safety remains at its forefront.
However, the CNIO needs to use other skills above their nursing experience. In order to perform their job effectively, the CNIO ideally should have a general understanding of the workings of hospital IT and a genuine passion and enthusiasm for new technology and change. CNIOs should also have the enthusiasm to learn to speak the language of technology, and articulate and educate nursing and clinical staff, who want to work with digital systems, about how to get the best out of technology for improved patient care. There are many challenges to technology adoption in healthcare, however, the rise of the CNIO is a huge leap in the right direction.
A digital future for nursing
Currently, the CNIO role in the UK is often overlooked, with hospital trusts apathetic to the role’s potential, struggling with financial and budget constraints or failing to clearly define the requirements of the role.
However, in organisations where the role has been implemented, the CNIOs have become well-respected drivers of change and central to operational management. As the digital healthcare revolution continues to take shape, I believe that this approach will become the norm, with CNIOs developing into influential, guiding forces that will help to steer trusts towards becoming effective and safe digitalised providers of healthcare.
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.