Sunday, November 16, 2008

Nursing and Technology

With future demands for healthcare increasing, it is estimated that the nursing shortage will range anywhere from 400,000 to over one million nurses needed in the U.S. by 2020. Pamela F, Cipriano, Chief Clinical Officer and Chief Nursing Officer at the University of Virginia Medical Center, speaking at the AMIA 2008 Conference held in Washington D.C. on November 11th, pointed out that in order to attract more nurses to the hospital setting, the hospital environment needs to be safe, efficient, automated, and operate with improved communications.

She continued to tell the AMIA attendees that if hospitals were adequately staffed, complications would be reduced, and in the end, hospitals would be able to operate more efficiently and profitably. For example, if a nurse in an acute care setting has eight patients instead of four, the risk of death for the patients’ increases by 31 percent. By adding just one full time RN per patient per day can help to eliminate deaths.

According to Cipriano, nurses today work in hospitals that can be extremely complex, chaotic, and generally operate with partial electronic and paper systems. Added to this environment, many hospitals are using non-compatible technology. The facts are that most hospitals are not able to provide for the rapid retrieval of data at the point-of-care. Today’s lack of technology in hospitals contributes to nurse burnout, retention issues, plus creates safety and quality issues.

Capiriano explained that the Robert Wood Johnson Foundation’s 2005 funding helped the American Academy of Nursing study the issue of using technology in hospitals and how this technology can help nurses in the field and avoid nurse burnout. The project called “Technology Drill Down” looked at how to improve efficiency and find the technological solutions to help improve workflow inefficiencies in the hospital setting. The project initiated discussions at 25 acute care centers representing over 200 sites, and at patient care units involving 1000 participants.

Group participants in the study identified major work categories and at the same time, analyzed their current work environment and process within each work category. The participants envisioned how the work should flow under ideal circumstances. Then the participants identified gaps between the current situation and the ideal environment. Processes that needed to be changed to reach the ideal state were identified and at that point, available technologies were discussed that could fill the gaps.

The nurses were in agreement that technology is absolutely essential to be able to retain nurses and to generally help the workforce. However specifically, they want to see the rapid retrieval of data at the point-of-care, the use of smart voice activated devices—especially wireless devices, the use of technology to do accurate tracking and scheduling, improved interoperable, integrated, and globally accessible communication systems, functionality that eliminates “work arounds”, and more robots used in hospitals.

Nurses would like to see hospital executives and technology vendors listen to the staff when designing and installing equipment. Essentially nurses want to be partners up front in the design of the technology and demand that the vendor’s products be thoroughly developed, tested, and affordable.