¶ … System Design Considerations and Workarounds

Implementation of an informatics system in nursing

The nursing profession continues to evolve with the advancing technology, ensuring that it maintains standards of quality in service. In the endeavor to facilitate quality healthcare, the profession endorsed the use of medical informatics systems. The nursing informatics integrates the three subjects of nursing science, computer science and information science. The practice employs these facilities in managing and communicating data and information while in line of duty. The informatics in nursing facilitates integration of information and knowledge to support the patients, nurses and doctors in decision making roles and administering of care (McGonigle & Mastrian, 2012). Information technology is essentially the significant aspect of the informatics; thus, it is necessary for hospitals to consider the quality of the technology they employ.

Medical informatics systems

The medical informatics systems support a variety of activities in the hospital or clinic setting. The systems concentrate largely in the areas of order entry and decision making as prominent areas of service improvement and error reduction (Australian National Health Informatics Conference, Maeder & Martin, 2012). In the hospital setting, as evidence of past occurrences reveal, serious medication errors and adverse drug events constitute many preventable deaths in hospitals around the country. These errors include actions such as overdosing of patient from misunderstanding or misreading the prescription notes. Another error is administering of wrong medication to the wrong patient, as well as, forgetting to administer medication at the indicated time. Additionally, human errors of the wrong decision-making due to poor analysis or evaluation of the patient can result to adverse effects. Thus, this necessitates the implementation of information systems to assist in providing quality and effective care to patients. The technology includes facilities that assist in managing patient information, medication schedules for patients, monitoring the personal progress of patients, as well as, making orders for the hospital stock of medication and giving receipts and drug prescriptions for patients (Joan, 2007). Drug alert systems can assist in maintaining the patient schedules for administering medication, reducing the grievous errors that occur due to nurse-human errors. Thus, in selecting the informatics system for nursing, it is necessary to ensure that the computers will meet the user requirements fully. These are the hardware, software and user considerations for the information system.

Design considerations for nursing informatics systems

In selecting the technology to use, there are various design factors to consider. The hardware considerations include the ability to upgrade the hardware. The second hardware consideration factor critical to the system is the maintenance of the system (Goveia, 2009). In the software considerations, include, compatibility and tailor-ability of the software, and the simplicity of use of the software. In the human factor considerations, the factors include the technical knowhow of the people to use the technology. The second human aspect is the willingness of the user to employ the technology. These considerations are crucial to the success of the informatics systems in the field of application.

The significance of considering these design factors includes the following. In the hardware considerations, the first factor is the ability to upgrade. Technology keeps on evolving as it has a remarkably dynamic nature. Therefore, the systems acquired for the nursing informatics should have the capacity to upgrade incase another property comes into the market that the nurses need (Buerhaus, 2013). If they are not upgradable, the costs of acquiring new system when technology improves or requirements go higher, are too high for hospitals to manage. Secondly, the aspect of maintenance is primary in considering the design to select. Technology and information systems are subject to wear and tear. Additionally, the system hardware can have defects; thus, it is essential to consider the facilitator of maintenance and the costs involved in the maintenance process. Maintenance of the system comes with the warranty, as well as, the person the customer chose to be maintaining the repairs.

The software considerations are equally significant to consider in selecting the design of an informatics system for nurses. The factor of compatibility and tailor-ability come in the aspect of implementing the new system. The system software of the new system should accommodate the old system to ensure a smooth changeover form the old system. The changeover phase determines the success of the new informatics system, thus if it is not compatible, the changing process can be expensive as parallel changeover is expensive; while the whole system changeover is highly risky. On the aspect...

Thus, the software should be tailored to meet user needs. The second software consideration is the ease of use. Before purchasing the software, it is essential to assess the ease of use of the software. The simplicity of application of the software determines the success of implementation of the informatics systems. An informatics system that has complications in using may require extensive training, which is an awfully expensive affair, in terms of resources and time. Thus, the software has to be easy to apply and use for the users.
Lastly, the human considerations for the information system have the same weight. The humans are the end users of the system. Thus, considering their requirements is equally significant for the success of the informatics system. The factors include the ability to use the systems that is technical knowhow. This will determine if there is further, training required, or the nurses can readily use the system. The second factor is the willingness of the nurses to adopt the new technology (Ball & Hannah, 2011). In various systems implementation procedures, the system fails due to unwillingness of employees to adopt the technology. Fears that the system would replace the people should not arise. The nurses need assurance that the system will not compete with them, but rather ease their work and increase efficiency. Thus, the nurses need to be willing to use the system for the success of the informatics system adoption.

Employee workarounds

In everyday running of the hospital setting, health care providers face challenges from poorly performing work systems, breaking of required equipment, failure of the system to communicate key information, and essential supplies running out. Nevertheless, the hospitals still manage to exhibit quality care despite the true magnitude of the problems of the work systems. The nurses can handle these challenges to provide care to patients. Thus, workarounds are part of the culture of healthcare facilities (Debono, Greenfield, Travaglia, Long, Black, Johnson & Braithwaite, 2013). Workarounds assist the professionals to circumvent and fix the emerging problems before situations get worse. They assist nurses to unblock the blocked workflow, solve problems, sidestep rules that hinder service, address the reduced workflow design and system issues, backup data, compensate for the inadequate technology, patch glitches in the software, facilitate shortcomings in staff, equipment and supplies, and save time. These are the benefits associated with implementing workaround by the nurse and doctors in the health centers.

On the negative side, the consequences of workarounds start from the establishment that workarounds is non-standard and outlawed way of going about duties. The workarounds have an opposite polar connotation that they are a subset of errors. Secondly, they are shortcuts and deviations that violate the procedural terms of offering quality care for patients. (Debono, Greenfield, Travaglia, Long, Black, Johnson & Braithwaite, 2013). Additionally, workarounds are subject to misuse as they rely on personal judgments of the person implementing the action. Therefore, to understand the factors of considering on determining whether workarounds are essential for the health care fraternity, weigh the positives against the negatives of the practice. In that perspective, it is notable that healthcare is a high-hazard industry, dealing with lives of patients; thus, mistakes lead to devastating outcomes such as deaths. The implementation of workarounds depends on the culture of the organization, thus, in the hospital setting; there is no room for eliminating workarounds.

Workarounds assist greatly as the informatics systems are subject to failure in extreme cases. Therefore, it is essential, when selecting an informatics system for use in the healthcare system, to consider the aspect of workarounds. Workarounds are necessary as emergencies do occur. These systems have their disadvantages and are subject to failure at some point. The workarounds assist in ensuring safety of the patients in case of such failures and faults occurring. However, it is essential to note that the use of workarounds should come as a measure of last resort as negligence and arrogance on the part of the nurse or doctor can lead to devastating effects. No system is perfect; thus, workarounds are necessary for the healthcare industry.

Conclusion

The healthcare environment handles lives of people, thus is a critical industry in the world. In developing informatics systems for the industry, it is essential to consider the aspect of perfection for those systems as errors and failures in the system can cause many problems. Workarounds are part of the culture of the nursing profession and are necessary for safety of patients in case of system failures.

References

Australian National…