Nursing Informatics

Nursing Informatics

Nursing Informatics

Technological developments over the last half century have transformed the quality of patient care. In defining the meaning of technology in nursing, Barnard (2002) suggested it is associated with sophisticated machinery, objects, computers, scientific knowledge and technical skills that are designed to enhance healthcare through nursing and medical practice. Examples of technology include patient monitoring equipment, computers and information systems, development of drugs and new clinical and diagnostic procedures and equipment. All of these place an increasing requirement for nurses to be competent and skilful in their use.

Locsin (2005) defined nursing practice as the deliberate and continuous use of technologies for the purpose of knowing persons as a whole, with technological proficiency being described as an enhancement of caring. Barnard and Sandelowski (2001) believed that nurses have dehumanised, depersonalised and objectified patients by depriving them of their individuality, subjectivity and dignity as human beings by meeting the needs of the machinery and equipment rather than those of patients. For example, attending to a problem with an infusion pump rather than spending time with a patient or leaving a patient to answer a call bell. There seems to be a greater reliance on the finished product or task, such as readings of a blood pressure performed by an electronic sphygmomanometer, a peripheral reading of a patient's oxygen saturation by a pulse oxymeter and a cardiac rate visualised by a cardiotelemetry. These are obtained other than by personally performing the task, by employing the essential observational, auditory and tactile skills. Walters asserted that 'giving primacy to the technological culture of Western biomedicine has the potential to render invisible humanistic nursing practice' (1995: 338).

The burgeoning use of technology in nursing and healthcare has witnessed the development of curious terms such as telehealth (Audit Commission, 2004), telemedicine and telenurses (eHealth Insider, 2005). There is now the opportunity to use personal digital assistants (PDAs) in teleradiology, electrocardiogram monitoring and mobile documentation (Tachakra, 2006), particularly by mobile emergency response personnel. Concepts such as 'electronic care' (desktop computer management of care), more familiar in healthcare delivery, progressing to 'mobile care' with the use of wireless technology tools such as PDAs compatible with current nursing care applications, is a future and exciting development (Saba, 2001). Examples in this context include text telephones for those with a hearing deficit, speech recognition software for the visually impaired, and unlit gas detectors for those with dementia and technically enhanced toys for children with specific learning needs (Bishop, 2003).

Technological developments are increasingly impacting on the work of the nurse whilst at the same time increasing the risk of errors being made and increasing the overall cost of healthcare. This brings with it a need for skilled and competent practitioners as greater demands are being placed on nurses to acquire relevant knowledge and skills.



Discussion

Davidson and Barber (2004) suggested that all patients on general wards are monitored with at least one piece of electronic patient monitoring equipment, either continuously or intermittently. There is a wide range of equipment available to nurses ...