INTRODUCTION:

Information and communication technologies (ICT) allow us to access information and communicate effectively and efficiently. Nurses have an excellent opportunity to contribute to innovation by using them to develop services for patients.

Technology is transforming healthcare delivery. Advances in diagnostic technologies enable practitioners to contribute to clinical decision making from a distance. For example, ultrasound scans can be transmitted over telephone lines for specialist opinion. In acute situations, paramedics can call on medical assistance using web technologies, while patients with long term conditions can use SMS text messaging to confirm blood results.

There are 15.4 million people with long term conditions in England and their care can be enhanced by using ICT. Davies showed that technology has made it easy for patients to access high quality, evidence-based information, making them more informed and able to manage their conditions more effectively.

The use of information and communication technologies (ICTs) for health, referred to as eHealth represent a means to support health care delivery. These technologies change how nurses plan, deliver, document, and review clinical care; this will only continue as technology advances. The processes whereby nurses receive and review diagnostic information, make clinical decisions, communicate and socialize with patients and their relatives, and implement clinical interventions will be fundamentally modified with further integration of ICTs into nursing practice. There is a wide range of ICTs used for supporting and providing health care. Mair et al suggested four general domains of eHealth that include a variety of ICTs: management systems, communication systems, computerized decision support systems (CDSSs), and information systems. Management systems allow for the acquisition, storage, transmission, and display of administrative or clinical activities related to patients, such as electronic health records (EHRs) or electronic medical records (EMRs). Communication systems can be used for diagnostic, management, counseling, educational, or support purposes.

They can be implemented to facilitate communication between health professionals or between health professionals and patients. There are a wide range of communication systems, varying from email and mobile phones to telemedicine and telecare systems. CDSSs are automated systems accessible from various devices, such as computer, mobile phone, or personal digital assistants (PDAs). They support decision-making for health professionals and assist them in practicing within clinical guidelines and care pathways. Information systems, such as Web-based resources and eHealth portals, refer to the use of Internet technology to access health-related information sources [1].

To support complex and diversified practices and interventions in nursing, myriad ICTs can be adopted, though not without challenges. Some ICTs, such as EHRs and computerized nursing care plans, facilitate access to patient information and help to document and plan nursing care. However, with the use of these technologies, nurses are expected to change the way they document patient care by shifting from paper-based records to electronic systems. The features (eg, copy and paste, electronic interface, drop-down menus) of electronic nursing documentation may affect critical thinking and accuracy of documentation. Telehealth technologies are another example, which include a wide range of ICTs such as remote patient monitoring, videoconferencing, and computer-mediated communications. In the case of remote patient monitoring (telemonitoring), nurses must be able to process a large quantity of data from the system (eg, vital signs, symptoms) and then use clinical decision skills to respond properly to each patient’s condition. In order to discern cues within the interactions via technological modalities, specific communication skills remain essential, i.e, active listening, facilitating conversation, questioning, redirecting, and verifying.

ICTs are becoming an impetus for quality health care delivery by nurses. It is thus relevant to study the role of nurses in the clinical use of ICTs as well as the impact of ICTs on nursing practices. The use of any type of ICT to provide direct or indirect care to patients may transform nurses’ day-to-day practice. In some systematic reviews, different types of ICTs have been reviewed, for instance, EHRs, nursing computerized records systems, or CDSSs. In general, nursing practice or nursing care was not well-defined in those reviews, and there was no conceptual framework enabling reflection on the way ICTs could influence indicators of nursing care. To overcome this gap, we used a broad and comprehensive conceptualization of nursing care based on the nursing care performance framework (NCPF) to embrace a multidimensional perspective of nursing care. The NCPF is composed of three distinct but interrelated subsystems: nursing resources, nursing services, and patients’ conditions. It is defined as “the capacity demonstrated by an organization or an organizational unit to acquire the needed nursing resources and use them in a sustainable manner to produce nursing services that effectively improve patients’ conditions.”

However, an integrated body of knowledge was lacking with respect to the effects of ICTs on nursing care, because of the heterogeneity of ICTs used in the literature as well as the poor Conceptualization of nursing care. We conducted an overview of systematic reviews to develop a broad picture of the indicators of nursing care that have the potential to be enhanced or constrained by the use of ICTs. The use of an overview is an interesting starting point from which to compare and contrast outcomes of separate reviews regarding the positive, negative, and neutral effects of ICTs on nursing care[2].

ICT USAGE IN NURSING CARE:

Nursing Administration:

Computers are used in the administrative areas of nursing for basic tasks that once were done on paper. Staffing and scheduling systems are used to construct daily, weekly or monthly schedules. Many scheduling systems also collect data on individual employees such as the amount of sick time used or vacation hours accumulated. Staffing and scheduling systems often provide a variety of reports to the administrative nurse. Budgeting and financial tracking are another way in which computers are used in nursing administration[3].

Education:

Computers are valuable for patient and nursing education. Hospitals often use computer programs to teach patients about chronic disease management or to provide educational handouts. Preprinted documents such as discharge or preoperative instructions can also be stored in the computer and printed as necessary. Nurses use computers for a variety of continuing education programs as part of the re-licensure process and can also complete educational programs on the computer to obtain advanced degrees[4].

Clinical Use:

Clinical applications of computers in nursing are numerous. Physicians prescribe medications and treatments on the computer, and the nurse can either transcribe those orders onto paper tools or print the paper documents for use in patient care. Staff nurses can order medications or supplies on the computer, look up drug interactions or research medical condition. Many nurses use hand-held computers such as personal digital assistants to communicate with physicians about the patients in their care[5].

Electronic Medical Records:

Nurses use computers for documentation with an electronic health record or electronic medical record. When an organization uses an EMR, all documentation related to patient care, diagnostic testing, specialty referrals or any other aspect of patient care or management is done on the computer. The computers can be stationed at the bedside, used on mobile carts or might be in the form of a portable electronic tablet that the nurse carries in lieu of a clipboard with paper documents[6].

How do nurses use computers in their daily work? Nurses use computers to:

· Record on the electronic health record your personal health-care story, the treatments they carry out for you, and your response and progress toward your health care goal for monitoring and for ready access by other team members.

· Obtain information about your past and ongoing treatments and medications and the results to ensure the best care is provided.

· Review data about your current and past health situation and plan of care on the electronic health record, which helps them monitor your recovery process over time.

· Access clinical knowledge such as drug information, nursing assessments, articles and nursing best practice guidelines and resources to better understand your health situation and plan of care.

What types of computers and information technology do nurses use?

· Nurses use computers similar to those that you use at home or at work. They use software programs specifically designed to support the work of nurses and other health-care team members.

· Nurses may also use a small hand held computer known as Personal Digital Assistants or PDAs. PDAs are very similar to the Blackberry or iPhone that you or your family and friends may use at home or work.

How do nurses use computers when they are busy with patients/clients?

· Health-care organizations may have a variety of computer devices in use –some are located at the reception desk or nursing station; others may be on carts or mounted on the walls throughout the organization.

· Mobile computers work from a wireless system which enables them to retrieve and store information remotely from the main computer.

· A mobile or handheld computer allows nurses to access your chart or record, view information, and make notes about your care from anywhere in their place of work.

Is my personal and health information private and confidential on a computer?

· Yes! Health-care organizations and health-care workers must follow very strict rules and regulations to ensure the computer system is safe and secure and that only those individuals with permission to view your health information have access to your record. Various users are authorized through secure passwords to access only those areas of your information they require to do their work.

How do computers and related information technology help nurses provide quality care?

· Computers enable nurses to quickly access important information about your health or illness and your treatment plan from your electronic health record.

· Nurses can access information such as your laboratory test and x-ray results and health reports from other health-care team members to give you the best care possible.

· Nurses can record your health information, treatments and progress for ready access and use by other health team members.

· Nurses may use the computer to search drug databases, libraries and best practice resources to obtain important information related to your diagnosis and care or find health education information for you.

What kind of information do nurses enter on the computer?

· Nurses enter the same type of health-care information and observations that were previously written in the paper chart including nursing treatments and the results.

· Nurses may enter details such as your blood pressure, temperature, effects of medication and treatments, and notes about how you are feeling to ensure the health-care team has your complete information.

· Nurses will also note your personal preferences on your health-care plan that all team members use to make informed decisions about your care and treatment.

Do all nurses and other members of the health-care team use the computer?

· In some organizations, there is widespread use of computers as an important tool for all members of the health-care team. In other organizations, computers are just being introduced.

· The use of computers for health-care organizations is increasing rapidly to support the use of an electronic health record and other related technological innovations.

Can I use the computer in my own self-care?

· Yes, there are many health-care web sites readily available to the public. However, some are more useful and accurate than others.

· There are a number of ways to assess the credibility of web sites, and knowing the source of the information and when it was made available are very important.

· Information from government, educational institutions, professional associations and health condition related organizations are usually reliable sources of health information. Some health-care organizations and governments have patient portals which are very informative and useful.

· Beware of commercial sources of data as they may be marketing a product or service.

· It is best to ask your nurse or other health-care provider for advice related to use of the internet based health information in your care. They can help you assess its quality and interpret it in relation to your health situation[7].

CONCLUSION:

Computer systems in health care increase the quality, safety, and consistency of patient care by providing nurses with quick and easy access to clinical information related to your health. These systems provide information and resources on best clinical practice and are a tool to quickly enter and share observations and information with all members of the health-care team.

REFERENCES:

1. Eng T. The e-Health Landscape: A Terrain Map of Emerging Information and Communication Technologies in Health and Health Care. Princeton, NJ: The Robert Wood Johnson Foundation; 2001.

2. World Health Organization. 2016. e-Health URL: http://www.who.int/topics/ehealth/en/

3. Carrington JM, Tiase VL. Nursing informatics year in review. Nurs Adm Q 2013; 37(2):136-143.

4. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academic press; 2011.

5. Monteiro AP. Cyborgs, biotechnologies, and informatics in health care - new paradigms in nursing sciences. Nurs Philos 2016 Jan; 17(1):19-27.

6. Mair F, May C, Murray E, Finch T, Anderson G, O'Donnell C, et al. NETSCC. 2009. Understanding the implementation and integration of e-Health services.

7. Sullivan DH. Technological advances in nursing care delivery. Nurs Clin North Am 2015 Dec; 50(4):663-677.

Received on 01.02.2018 Modified on 04.04.2018

Int. J. Nur. Edu. and Research. 2018; 6(3):299-302.

DOI: 10.5958/2454-2660.2018.00072.8