Technology in nursing: applications and integration

Technology in Nursing

History of technology and its influence on nursing

There is now a great influence on the impact of technology on the practice of nursing and if the well-known behavior scientists like Abraham Maslow had been around and invited to give his opinions regarding influence of technology on human life, he may not have considered technology as being essential for the existence of human lives. This is clear from the fact that humans lived prior to the discovery of cell phones, e-mail, fax machines or even the Internet. The important point for us to consider is whether there is such a high importance for these technology for human existence. The use of technology is often made so that we are able to get new and innovative strategies so that patient care delivery is improved. The attempt is now often to seek technological solutions for the nurses to be able to operate more effectively and continue with their jobs. (Richard, 2004)

This can be seen in many areas and if the medication is not being delivered in the system of the patient properly, there is use of bar coding of the medicine to ensure that medicines reach the patient properly. When we notice some other problems like the patients falling off from the beds, then there are bed alarms that are installed so that the quality of nursing improves. In other diseases like decubitus ulcer, the solution that is sought most often is to get high-tech patient beds to reduce the chances of skin breakdown of the patients. These sorts of examples may certainly be considered to be the correct uses of technology so that the patients can be helped in the best possible way. At the same time, these changes should not be viewed as some sort of a magic to solve the problems of patients, but should be treated as methods to solve the problems of patients. (Richard, 2004)

The use of technology is very useful even in solving the problems of shortage for nurses that we have now. The president of American Hospital Association, Dick Davidson has states that America needs another 126,000 nurses right now apart from a large number of pharmacists, lab technicians, support staff and other individuals. He has also invited for immediate action to be taken to solve these problems. The problems can be solved to some extent through the use of clinical information systems and provide a lot more confidence to the nurses. These systems will stop medical errors, streamline workflow and communications, reduce unnecessary entry of data and the total effect can be thus lasting and positive. We have a shortage of trained manpower and certainly these machines can help in that regard. (Meadows, 2002)

The development and usage of technology for nurses has started from the middle of their courses and they have computer assisted instruction along with the knowledge of development of humans, knowledge about Internet, and learning about development of program development. (Siktberg; Dillard, 1999) At the same time, there seems to be a lot of interest in the study of development of nursing through the impacts of scientific influences. One study was to know about the result of phenomenon so that one could find out the qualitatively various methods by which technology is understood and experienced by nurses of the present period. (Barnard; Gerber, 1999)

There have also been qualitative studies which examined ways of understanding technology in surgical nursing and examine the implications that this technology has for nursing and health care practices. (Barnard, 2000) There have also been online surveys of the technological capacities of U.S. undergraduate programs and the results were that most of the nurses were using Microsoft Windows-based computers and Microsoft Office software for their use. (Wells; Wilkie; Brown; Corless; Farber; Judge K; Shannon, 2003) Some of these studies are probably studies for the sake of studies as they are not likely to lead to any benefits for the patients or nurses. After all it is well-known today that almost everybody is compelled to use Microsoft programs for computers as nothing else practically exists.

At the same time, there is no doubt that some types of technology are helping the development of nursing techniques and storages. One of them is the improvement of mobile technology and this is on the way to create mobile health systems. The changes are due to increases of availability, miniaturization, performance and cost effective bandwidth. These developments are likely to deliver cost effective technologies which will in the end improve the delivery of care by the health care organizations. Some other changes have already taken place through picture archiving and communication systems and these have practically made the radiological film practically out of date. (Simpson, 2003)

The new system permits users to acquire, store, transmit and display images digitally and the end result is a clinical environment where there are no films. Another important system is the computerized provider order entry and these are designed to find out and stop medical errors during the process of treatment at the earliest possible point. When this system is installed, the person providing the medicines enter the orders into a computer and then the computer itself checks the order. It is able to find out incorrect dosages and drugs, drug allergy interactions, interactions between different drugs, and many other possible errors. The system is able to improve the process of treatment through ensuring that the right drug is administered, at the right time and also inform others if the condition of the patient changes. (Simpson, 2003)

It is most important that tools of technology are used to increase interactions between different human elements in the process of treatment. The impact of technology is on the way that care is delivered to the patients, and also that the correct treatment is given at the correct time. Technology is not a substitute for care but only a supplement that will improve the quality of care. Remember it is the patient who is the most important in the entire issue for the use of correct technology. (Richard, 2004)

How have the values and beliefs of nurses and other healthcare providers influenced the evolution and usage technology in nursing?

It is difficult to judge the acceptance of new technology among any group except through their reactions to the change that it causes. As we know very well, the change that is caused through any change in technology will cause changes in work schedules and other matters for nurses. Let us look at the studies of an individual who had been studying the employment mobility among nurses and find out the reasons for it. The important point is not only to find out how often they change jobs, but also their individual reasons for changing of jobs. The important matter of this study was that there was a study which considered not only a shift from one institution to another institution as a nurse, but also within the same organization as a nurse in different areas. (Nursing profession studied)

What this means is the shift of a nurse from the operating room to a palliative care nurse. The jobs are different and the initial study did not indicate a high degree of shifts within the nursing profession, but when studies the total data comprehensively, it is seen that there is quite a rapid shift of nurses. The latest available data available in this study is for 1991-92 and it shows that within a one year period, there were shifts in the employment status of 12 to 15% of the nurses. The change could have been for any reason like status of employment, place or setting or even the type or position. This makes it clear that during a period of one year, roughly about a third of the nurses change their job, at least in terms of characteristics. (Nursing profession studied) Thus there is a fairly rapid turnover of nurses and the net important question is to find out the reasons for change.

In more than 90% of the cases, the nurses clearly stated that they had left their jobs voluntarily, and the proportion is more than 90%. Only in about three percent of the cases, the reasons for change was mutual between the nurse and the employer and in two percent of the cases, the nurse had been dismissed from their jobs. Clearly there is no desire among employers to dismiss nurses, since costs are involved in recruiting nurses, training the nursing staff and these costs are substantial for a hospital. Thus in spite of all the technical changes that have been going on, the reactions among the nursing staff is not very aggressive. There are some reasons for changing jobs that the nurse cannot avoid - like the shift of the spouse to another city on a job. This sort of a case also cannot be influenced by the hospital administrators. It is only when the nurses leave due to working conditions, it is clear that either the nurses are not able to match up to the changes, or the behavior of the hospital is not suitable. (Nursing profession studied) This is clearly not very high, and there does not seem to be a high impact of the change in technology on nurses and their employment.

This leads to a dichotomy in the view about nurses - they are viewed as targets of change rather than the force which leads to changes through proposals, leadership and implementation. This often causes them difficulty in carrying on with their jobs when there are rapid changes within the organization. To save their own position, it is important that nurses learn about change theory, change strategies and methods of anticipation and managing change. This may take place in organizations which wants to change its staff mix so that it can save on costs through inclusion of more unlicensed assistive personnel. These personnel will generally try to maintain their position through direct assertion, but there have to be an analysis of the driving and restraining forces before any decision is finally taken. (The Power of Change)

The driving reasons for the proposed change may be an increase in patient care hours that the hospital has to face, decreased charges that can be levied, elimination of non-professional tasks that are carried out by the registered nurses and additional time that has to be spent by them for teaching patients and their families. On the other side, there may be restrictions due to the lack of control over care for patients, concerns and worries about the supervision of unlicensed staff, the desire of maintaining the present situation and getting into any changes, and the conflict between the new staff and the old. Their may be conflicts in many cases between the new group and the old group, and the group planning the change may have their own views. These generally lead to a halt to the entire process till the conflicts are resolved. This is also the situation when the process of education and usage of technology among nurses start in any organization.