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Do Clinical Information Systems Detract from the Humanistic Side of Patient Care?
Why We Need Clinical Information Systems
Movement Towards Clinical Information Systems (CIS)
Healthcare’s movement towards technology holds many advantages. Does this movement detract from the humanistic side of patient care? No, it simply supplements it. McGonigle and Mastrian (2009) mention several of the advantages of utilizing clinical technology:
Easy access to patient data
Structured and legible information
Improved patient safety such as prevention of drug reactions and identifying risk factors
Easier and timelier quality assurance resulting in better feedback for improvement
Nursing administration assistance to prioritize educational needs of staff
CIS: Assist the Nurse
The clinical information system (CIS) in my workplace has cues built into the admission assessment screen prompting nurses to ask certain questions, discuss particular safety issues, and educate on new diagnoses, procedures, medications, and hospital policies. The initial screen even tells the nurse to say certain words explaining the need to be looking at the computer screen, that the nurse is not meaning to be rude, and that the patient is important. The functions assist the nurse to ensure complete and thorough documentation while facilitating communication with the patient.
Aid Morality and Team Unity
The technology movement can also aid with morale and team unity. Nurses, new and old, must understand the goals for implementation of information technology and drive the selection of clinical technologies. Two goals that should guide nurses include: enabling safe and efficient care and measuring nurses’ impact in keeping patients safe and promoting health and recovery (“Nurse Leaders”, 2010). Remembering these goals may assist the aging nurse population is accepting the new technologies. Involving both new nurse and more mature nurses will promote bonding of nursing generations, respect, and staff ownership (“Nurse Leaders”, 2010).
Teamwork is facilitated at my workplace by CIS, as many nurses can provide care for and document on a critical patient at once. Admitting a critical patient could take the entire shift if multiple nurses were not able to use CIS for information and documentation. A staff member can be processing computerized physician orders, one can be performing and documenting the assessment, one can be retrieving old chart electronically for patient history information, one can access and document medication administration, and one can initiate the careplan simultaneously with the common goal of initiating care and completing the admission.
Clinical information systems (CIS) can benefit nurses when communicating with physicians. No longer do all nurses have to look up pager numbers and wait for a call back to get orders. Computerized physician order entry (CPOE) provides a quick and efficient method, also having the safety factor of being clear and legible. Physicians can them view the results of their orders on the computer remotely. McGonigle and Mastrian (2009) mention “integrating communication systems with clinical applications provides a real-time approach that will facilitate care among the entire healthcare team” (p. 207).
Use Caution with Students
I have seen a negative aspect of technology when supervising students in a practical nursing program. I found that students were more likely to spend time on the computer than with their patients when in clinical areas that integrated a high level of technology. I had to enforce patient cares and show how the computers can facilitate interaction.
As educators, it is important that we recognize how technology is effecting newer generations and their perception of what nursing care is. We must remind them about the importance of human touch and empathy. Students and new nurses must understand that even in the movement to go paperless, nurses can still give back rubs. McGonigle and Mastrian (2009) state “it is not the type of systems that are important but the method in which they are put into practice” (p. 217).
CIS can open further opportunities for nurses. The scope of CIS has expanded in some organizations to include professional development training tools (McGonigle & Mastrian, 2009, p. 194) It can also provide creativity for staff development and educations. McGonigle and Mastrian (2009) elaborate “the pop-up box education format has encouraged staff to share the answers, thus creating interaction, knowledge dissemination, and reinforcement of the education provided” (p. 200).
The future holds many advances and opinions involving CIS. It is the responsibility of nurses to ensure that it continues to supplement a humanistic approach to nursing care. “Computers and other technologies have the potential to support a more client-oriented healthcare system where clients truly become active participants in their own healthcare planning and decisions” (McGonigle & Mastrian, 2009, p. 216).
What Do You Think?
New nurses view electronic CIS's in a positive light while more experienced nurses view CIS's in a negative light
McGonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett.
Nurse leaders discuss the nurse's role in driving technology decisions. (2010). Virginia Nurses Today, 18(1), 8-9.