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Nurses still struggling to influence IT

23 July 2013   Lis Evansted

The Royal College of Nursing has called for more nursing input into IT and more IT training for nurses after a survey uncovered a lack of confidence in clinical systems.

The survey of 1,000 RCN members found the majority of nurses had no influence on the way technology was used in their workplace.

Just under half (46%) said they had not been consulted at all about the introduction of IT systems and 54% said they had not been able to influence their use, even though 85% used a variety of systems on a daily basis.

In addition, the survey found that many nurses are still struggling to share PCs, instead of using more modern technology at the bedside.

A report on the survey says: “35% stated they had insufficient access to ICT equipment, or that the type of ICT tools they used were inadequate for their roles.”

Dr Peter Carter, chief executive and general secretary of the RCN, said: “We would like to see nursing staff more involved in the implementation of e-health to ensure the focus of new technology is always on how it can improve care for patients.”

The RCN report - ‘Positioning nursing in a digital world’ – suggests that nurses should have influence on trust boards and clinical commissioning groups “to promote nursing input to service transformations facilitated by e-health.”

It suggests this would also “ensure that the nursing workforce is supported with appropriate ICT tools and systems, and competence in informatics.”

Around a fifth of the survey respondents said they had received no IT training for three years or more, with more than half of these saying this was down to a lack of ‘protected time’ for courses.

One respondent said that the training opportunities were very poor and that wards were too busy for IT training to be prioritised. Another said that because they had never received proper IT training: “I don’t feel comfortable and competent.”

The report also says that 63% of respondents working in NHS community services and 59% of those working in NHS hospitals reported that they have no IT support after 5pm.

As well as problems with involvement, training and equipment, the survey uncovered complaints about the accessibility of IT systems. Almost half of the survey respondents reported that it takes too long to log-on to multiple systems.

The report adds that although some nurses were positive about the benefits of e-health, “others expressed concerns about technical problems, training needs, increased workload, the potential detrimental impact on nursing care, e-health and the scope of ‘nursing’, and lack of leadership.”

“In conjunction with an identified lack of consultation and limited opportunities to influence ICT developments, these attitudes could result in users failing to engage fully with future projects,” it concludes.

 

 


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Last updated: 22 July 2013 15:55

© 2013 EHealth Media.


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Maria.nicholson@jigsaw-partnership.co.uk 68 weeks ago

System development needs to ensure that usage of the system is I tuition and simple to follow - just like twitter, Facebook, on-line banking et al... Systems used by millions.

We need to get to a stage whereby training on such systems for daily operational use need no more than 30 minutes. Only then will it be possible to get people really engaged. For super user/admin functionality obviously more training is needed but in reality if you are going to be using something daily/weekly, it needs to be simple flagging for next area to be completed etc..

It is absolutely vital to get nurses and clinicians, technicians involved at development stage, at sales stage, at procurement stage and implementation stage.. Then you can be assured of successful transition from development to operational usage.


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shared responsibility....

nursemaia 72 weeks ago

I agree with many of the thoughtful comments above, and think that in general nurses are not given a chance to engage early enough in the decision making process. Sure, nurses on the shop floor are busy and will always prioritise patient care over what they see as unimportant administrative tasks. The way forward is probably for IT to employ nurses for engagement/deployment of IT systems.

My trust has employed myself and another nurse as part of a small team to facilitate the roll out of EPMA, and I really believe that without any clinicians on board the project would have been much bumpier! Lets face it, IT and nursing couldn't be more different spheres, so they need to inform each other, communicate, overlap.

I disagree that 'post project 2000' generation are unlikely to re-design or expose workflows - in recent years nursing education has a massive change management focus. I can't comment on higher management strategy, but when it comes to the guts of implementing new IT systems, IT projects need nurses/clinicians/pharmacists out there driving the changes.


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TCM - training, communication and management

ehireader18to14to12 73 weeks ago

technicians and developers need to be able to speak directly with Nurses

on the side, qualified Nurses convinced me (thanks) to stop using the term "18 week wait pathways" and start using the term "patient pathways" - that was putting the patients 1st, the pathways belong to the patient ...

on the - side, some Nurses were reluctant to move from character UI to graphical UI (bit fiddly), that cost the suppliers significant amounts of money (2 code streams) which of course would be passed on - wasting  is not putting the patients 1st

the reluctance was probably due to poor communication, lack of training and poor management

apologies for repeating myself but the NHS needs to learn from history and not make the same mistakes - technicians and developers need to be able to speak directly with Nurses and other clinicians (and by the way, the NHS needs to have some courage & raise the profile of patient pathways, thereby putting the patient 1st)


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Nursing Informatics

CertaCitrus 73 weeks ago

Have to agree with a number of comments already posted.

Main points I've seen:

(Senior) Nurses are keen to work on the IT systems but were very limited with time. It has to be senior nurses as they are making changes to the workflow, etc [Back to the it's not an IT adage]

Nurses are keen to record information electronically but a number of systems are cluttered with reporting data and that makes it difficult to use. Where a simple system is used (e.g. simple text box for progress notes), they tend to have accurate information recorded and are used often.

Management/IT admin tend to push systems towards reporting data . They need to understand more about how nurses use information e.g. assessments, care plans, goals, interventions, progress notes, etc. (I found it quite difficult to find this out, nursing informatics tends to concentrate on using IT/IT training rather than how nurses use information).


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Make IT convenient for nurses

stuartrankin 73 weeks ago

Time-consuming and technical software training is clearly a big issue for busy nurses who have many patients relying on them at any one time. To remove this barrier for adopting new technologies within hospital wards, we as software providers, need to create solutions that are easy-to-use, intuitive and require minimal training.

A rigid, one-size-fits-all solution is not appropriate for every ward as each has its own set of requirements, making it clumsy and difficult for the end user to operate. Making nurses part of the development process of IT solutions will help software providers realise the day-to-day issues the frontline faces, meaning solutions can match current processes or support change management programmes more effectively, leaving nurses with more time to care.


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Make IT convenient for nurses

benjimagrat 72 weeks ago

I agree. I'm sure plenty of these nurses are on Facebook, twitter and can book a holiday online. I would be fairly sure that none of them needed to go on an IT training course to learn how to use it.

A lot of systems I have used show lots of different menu's that just don't get used. If systems could be easily configured by team, role and even the user then they will only see the information that is relevant and useful to them.


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mrtablet 73 weeks ago

Nursing records are a major part of the bulk of traditional inpatient paper notes.

Nursing records, care plans etc. are often on paper form templates, with checkboxes and boxes / 'headings' with usually fairly brief free text entries. There are 'default' entries (or a small selection of them) to pre-populate many fields which could then be edited.

On the face of it there are opportunities to make many of these records electronic and save data entry time.

So what has gone wrong?

I seriously doubt there is systematic prejudice against including nursing staff in healthcare IT projects. Their sharp end of care delivery makes them a 'must have' in any credible secondary care system EPR/EMR project. The high penetration of nurses into NHS senior management positions would also augur against exclusion.

Might I suggest another factor?

Professionals engaging with IT projects open their workflow and documentation to scrutiny by those outside their own profession. Might the leaders of the post-Project 2000 generation be a little hesitant of exposing shibboleth to process redesign?


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1000 nurses were asked in an RCN survey........

in arduis fidelis 73 weeks ago

%u21CIn conjunction with an identified lack of consultation and limited opportunities to influence ICT developments, these attitudes could result in users failing to engage fully with future projects,%u21D it concludes.

In my not insubstantial experience trying to consult with, trying to engage with and trying to get nursing staff to attend training in technology being used or new technology the general response I have encountered does not match up with the RCNs official survey results - easier to blame others for their lack of engagement rather than the reality of - "I havent got time for that" and "whats that got to do with me" and "I've done it this way for 20 years so I'm not going to change now because it works" and the classic "show that to the admin team".

Hopefully a balanced approach to how the "accurate survey" results are assessed and acted on will be taken, there are two sides to every argument after all.............and please if they are to recieve more training it should be on the job not taking more time away from patients and it should be a general requirement for all Nursing staff, lets not create more silos


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