Nursing Informatics Systems: Design and Workarounds
This paper examines the implementation of informatics systems in nursing, covering the integration of nursing science, computer science, and information science to support clinical decision-making and patient care. It identifies key design considerations across three dimensions: hardware (upgradeability and maintenance), software (compatibility, tailor-ability, and ease of use), and human factors (technical competency and staff willingness to adopt new technology). The paper also addresses the role of employee workarounds in healthcare—evaluating both their benefits, such as unblocking workflow and compensating for system failures, and their risks, including procedural violations and reliance on individual judgment. The discussion concludes that workarounds remain a necessary cultural reality in nursing practice, particularly as a safeguard when informatics systems fail.
- Introduction to Nursing Informatics: Defines nursing informatics and its foundational role
- Medical Informatics Systems in Healthcare: Types of systems and common medication error problems
- Design Considerations for Nursing Informatics Systems: Hardware upgradeability and maintenance as design priorities
- Software and Human Factor Considerations: Compatibility, ease of use, and staff adoption factors
- Employee Workarounds in Healthcare: Benefits and risks of nurse-initiated workarounds
- Conclusion: System quality and workarounds essential to patient safety
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What makes this paper effective
- Organizes design considerations into three clear, parallel categories (hardware, software, human factors), making the argument easy to follow and evaluate.
- Balances theoretical framing with practical implications, connecting each design factor to real-world consequences such as cost, risk, and adoption failure.
- Presents a nuanced view of workarounds by acknowledging both their operational value and their inherent risks, avoiding an oversimplified verdict.
Key academic technique demonstrated
The paper demonstrates structured comparative analysis: it introduces a framework (three design dimensions), applies it systematically across hardware, software, and human considerations, and then pivots to a second framework (pros vs. cons) for evaluating workarounds. This dual-framework approach allows the author to build a cumulative argument rather than treating each topic in isolation.
Structure breakdown
The paper opens with a definition of nursing informatics and its importance, then describes the types of errors that motivate system adoption. The body is divided into design considerations (spread across two sections) and a dedicated section on workarounds. Each section follows a claim-then-justification pattern. The brief conclusion synthesizes both threads—system design quality and workaround necessity—into a single closing statement about the high-stakes nature of healthcare informatics.
Introduction to Nursing Informatics
The nursing profession continues to evolve alongside advancing technology, ensuring that it maintains standards of quality in service. In the endeavor to facilitate quality healthcare, the profession has endorsed the use of medical informatics systems. Nursing informatics integrates three disciplines: nursing science, computer science, and information science. The practice employs these fields in managing and communicating data and information in the course of clinical duty. Informatics in nursing facilitates the integration of information and knowledge to support patients, nurses, and doctors in decision-making roles and the administration of care (McGonigle & Mastrian, 2012). Information technology is essentially the core aspect of informatics; thus, it is necessary for hospitals to carefully consider the quality of the technology they employ.
Medical Informatics Systems in Healthcare
Medical informatics systems support a variety of activities in hospital and clinic settings. These systems concentrate largely in the areas of order entry and clinical decision-making, which are prominent areas for service improvement and error reduction (Australian National Health Informatics Conference, Maeder & Martin, 2012). In the hospital setting, as evidence from past occurrences reveals, serious medication errors and adverse drug events constitute many preventable deaths in hospitals across the country. These errors include actions such as overdosing a patient due to misunderstanding or misreading prescription notes, administering the wrong medication to the wrong patient, and failing to administer medication at the indicated time. Additionally, human errors in decision-making caused by poor analysis or evaluation of a patient's condition can result in adverse effects.
This reality necessitates the implementation of information systems to assist in providing quality and effective care to patients. Such technology includes tools that assist in managing patient information, maintaining medication schedules, monitoring individual patient progress, managing orders for hospital medication stock, and generating receipts and drug prescriptions for patients (Joan, 2007). Drug alert systems can assist in maintaining patient medication schedules and reducing the serious errors that arise from human error. Thus, in selecting an informatics system for nursing, it is necessary to ensure that the computers will fully meet user requirements. These requirements fall across hardware, software, and human factor considerations.
Design Considerations for Nursing Informatics Systems
In selecting the appropriate technology, there are various design factors to consider. Hardware considerations include the ability to upgrade the system and the ease of its maintenance (Goveia, 2009). Software considerations include the compatibility and tailor-ability of the software, as well as its simplicity of use. Human factor considerations include the technical knowledge of the people who will use the technology and their willingness to adopt it. These considerations are crucial to the success of informatics systems in their field of application.
Regarding hardware, the first consideration is upgradeability. Technology has a remarkably dynamic nature and continues to evolve rapidly. Therefore, systems acquired for nursing informatics should have the capacity to be upgraded when new capabilities enter the market (Buerhaus, 2013). If systems cannot be upgraded, the costs of acquiring entirely new systems whenever technology improves become prohibitively high for hospitals. The second hardware consideration is maintenance. Information systems are subject to wear and tear, and hardware can develop defects; thus, it is essential to evaluate both the provider of maintenance services and the costs involved. Maintenance of the system is typically governed by the warranty terms and by the service provider the hospital selects.
Conclusion
The healthcare environment handles human lives and is therefore one of the most critical industries in the world. In developing informatics systems for the industry, it is essential to strive for the highest possible quality in those systems, as errors and failures can cause significant harm. The three dimensions of hardware, software, and human factors must all be carefully evaluated during the selection and implementation process. Workarounds are part of the culture of the nursing profession and remain necessary for patient safety in the event of system failures. Ultimately, the goal is to implement well-designed, reliable informatics systems that minimize the need for workarounds while ensuring that staff are prepared to respond effectively when systems fall short.
References
Australian National Health Informatics Conference, Maeder, A., & Martin-Sanchez, F. J. (2012). Health informatics: Building a healthcare future through trusted information; selected papers from the 20th Australian National Health Informatics Conference (HIC 2012). Amsterdam: IOS Press Inc.
Azad, B., & King, N. (2008). Enacting computer workaround practices within a medication dispensing system. European Journal of Information Systems, 17(3), 264–278. doi:
Ball, M. J., & Hannah, K. J. (2011). Nursing informatics: Where technology and caring meet. London: Springer.
Buerhaus, P. I. (2013). Human factors engineering, bar coding medication administration, and nursing: An interview with Drs. Richard Holden and Laurie L. Novak. Nursing Economics, 31(4), 190–193, 197.
Debono, D. S., Greenfield, D., Travaglia, J. F., Long, J. C., Black, D., Johnson, J., & Braithwaite, J. (2013). Nurses' workarounds in acute healthcare settings: A scoping review. BMC Health Services Research, 13, 175. doi:http://dx.doi.org/10.1186/1472-6963-13-175
Goveia, T. (2009). Comparing notes on workload, patient care and the use of IT. The Canadian Nurse, 105(4), 24–29.
Joan, R. B. (2007). Essentials of nursing informatics, 4th edition. Nursing Education Perspectives, 28(2), 98.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge. Burlington, MA: Jones & Bartlett Learning.
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