The Nurse as Knowledge Worker with Mobile Access for Patient Care

Nearly three-quarters of nurses use smart phones on the job, according to a recent study by healthcare publisher Lippincott Williams & Wilkins.

The same study found that 66 percent of nursing students use smart phones in nursing school.

Recognizing the mobile trend early, TeleTracking has been offering hand-held PDAs for years so nurses can access its patient flow software from anywhere in the hospital. Now we offer apps for other mobile appliances.

The mobile revolution in healthcare won’t stop, but it is being slowed down by hospital policies and cultures which aren’t keeping up with technology. Some hospitals ban the use of smart phones at work because of privacy concerns. Other common impediments to adoption include a culture which resists change, a lack of training, and outdated processes.

But three major trends are forcing the issue:

• The move to evidence-based decision making. The pressure is on for nurses to make sound, evidence based decisions, especially regarding the prevention of complications. They now face a deluge of data and need guidance in finding the right data for the task at hand. This requires on-the-job training for veteran nurses and close cooperation between educational and healthcare institutions for the benefit of future nurses. And it also requires bedside access to that data.

• The adoption of Electronic Medical Records (EMRs). The evolution and widespread expansion of EMRs require nurses to become familiar with that technology and to have easy access to those records.

• The expansion of enterprise-wide “real-time capacity management” systems.  Real-time capacity management gives nurses better control over the physical environment, including the ability to track patients, doctors and other staff, locate empty beds, order transporters, determine overall capacity, and digitally  follow their patients through procedures, among other things.

Having the ability to do all of the above with a hand-held device is a huge boon for efficiency. But roadblocks still exist.

To balance the onslaught of technology with the human factors involved in adopting that technology, a new role is emerging—the chief nursing informatics officer (CNIO).

According to Linda Hodges, senior vice president IT practices for Witt/Kieffer, the CNIO is “the leader for nursing in the design and execution of technology-enabled process changes that maximize patient safety, quality of care and operational efficiency.”

Among the first orders of business for the CNIO is to engage nurses in the software planning, selection, implementation and management of new systems, according to Ainslie Nibert, vice president of review and testing, Nursing and Health Professions.  This has historically been TeleTracking’s regular routine with new clients and we have found it to be key to nursing acceptance and satisfaction of capacity management technology.

We were originally enlightened about engaging nurses by our own consultants, all of whom are nurses who participated in such exercises at their former hospitals. We learned that given the opportunity, they were very adept at ascertaining what technology was best for them and how that technology could be improved to help them with their jobs. In fact, now our clients are some of our best innovators.

But change is seldom easy. Giving nurses these new responsibilities means accepting that they have an elevated role in healthcare – beyond care giver to knowledge worker. The sooner everyone gets on board with that idea, the better off we all will be.