Challenges Encountered by Nurses
Outline
- Introduction
- Electronic Clinical Documentation Project
- Lewin’s Theoretical Framework
- Application of Lewin’s to Nursing
- Conclusion
Abstract
The healthcare setting is constantly transforming and developing. Nurses are making countless steps to acclimatize with these transformations in order to fit in the compound health care requirements. The shift to automated documentation is a high-tech transformation that has noteworthy impacts on the nursing career and the general health care system. This process of documentation can assist nurses in addressing barriers that ensue as a result of using paper work documentation in healthcare facilities. Electronic documentation also enhances the precision and extensiveness of patient data and thus facilitating delivery of quality nursing care. Even though electronic documentation is advantageous, several barriers occur that obstruct the execution of electronic documentation systems. In order to effectively execute this project, the nurse should be in position to identify and find a solution to these challenges. The purpose of this paper is to define electronic clinical documentation and find out how the enactment of this project can address challenges normally encountered by nurses. This paper also looks at a synopsis of Kurt Lewin’s Force Field Analysis Model and deliberates how it can be functional in the practice situation to effectively execute the hypothetical nursing informatics development.
Challenges Encountered by Nurses
Introduction
Developments in processors and information technology have considerably played a major role in the transformations in the nursing career and the general health care system. Currently, in the health care setting, it is vital for nurses to acclimatize with the technological developments so as to address the compound health care concerns and provide the best nursing care (Ross-Kerr, 2003). Quality care is significantly determined by a nurse’s aptitude to access precise and ample health data. The evolution from paper to electronic recording can expedite this procedure and advance the quality of nursing citations. This technological transformation reduces the ineptitudes emanating from paper-based registering. Obviously, the application of electronic documentation is vital to improve the delivery of safe, proper, and effective nursing care.
The computerization of nursing filling systems obliges both operational and behavior change (Kelley, Brandon, & Docherty, 2011). Because nurses are habitually resilient to change, the application of automated documentation can be a demanding attempt (Bozak, 2003). Kurt Lewin’s hypothetical framework validates the intricacies that happen as a result of the change process and offers a strategic approach to support the enactment of this technological advancement (Bozak, 2003). The purpose of this research is to define automated healthcare documentation and offer a description of hypothetical nursing informatics development. The research will offer a wide assessment some literature to find out how the execution of electronic documentation can address barriers and problems encountered by nurses. The paper will also pinpoint barriers that nurses can encounter in the implementation of this electronic documentation.
Electronic Clinical Documentation Project
This is an electronic data system used by nurses as well as other healthcare specialists to methodically document clinical data of the health of a person. In healthcare setting, thus process is called patient’s electronic health or medical record. Information enclosed in this file contains, valuation data, treatment orders, clinical involvements, care strategies, check in, nursing accounts, laboratory statistics, and patient results. This record in significant in enhancing a planned communication between nurses and other health care practitioners to enhance the provision of quality care. According to the Association of Registered Nurses (2010), both automated and paper documentation are fundamental constituents of nursing care. Nevertheless, research has shown that evolution from paper to automated documentation can have substantial inferences to patients, nurses, and the general health care system. The electronic documentation project can provide solutions to numerous problems encountered by nurses in meeting their career goals (Pfortmiller et al., 2011). In accordance to the review of literature, it is apparent that nurses currently encounter numerous problems that deter their capability to offer quality care. Even though nurses encounter several barriers in their areas of practice, this research will emphasis on some matters that can be solved with the implementation of electronic clinical documentation.
One key barrier for nurses in healthcare facilities is the quantity of time consumed recording data of patient’s information. According to the research by PricewaterhouseCoopers (2001), nurses use roughly 30 to 60 minutes carrying out paperwork for each hour in their provision of patient care. According to Poissant et al (2005), nurses consume almost two to three hours in their shift filling forms and documenting clinical information manually. Even though clinical documentation is indispensable, numerous researches have indicated that the shift from paper to automated documentation decreases the time that nurses devote recording patient data thereby permitting more time to offer patient care (Yee et al., 2012).
Unfinished and unreadable information documentation are noteworthy concerns that inhibit a nurse’s aptitude to access and precisely construe clinical verdicts in paper records (Turisco & Rhoads, 2008). According to Menke et al. (2001), electronic systems eradicate the necessity for hand scripts thereby ensuring more clear and ample patient information. Computerized systems also curtail the probable of misplaced or unclear data that is common with paper based recording. Furthermore, these methods enhance the precision of client’s data. Though effective data presentation, there is timely communication between different healthcare practitioners thus promoting steadiness and the general nursing care.
From the literature above, it is apparent that effective application of computerized patient records is significant in enhancing nursing documentation and thus safeguarding and improving quality care. Consequently, nurses experience increased levels of job gratification, which has a positive effect on their output, patient gratification, and general accomplishment of health care facilities (McHugh, 2004). Notwithstanding the prevailing proof that supports the advantages of computerized documentation, the evolution from paper to automated documentation has also key barriers within health care facilities.
There are several barriers, which inhibit the effective application of electronic. Many researchers emphasize on nurses’ approaches towards the whole process of enactment of the technology (Pfortmiller et al., 2011). According to research by Pfortmiller (2011), the application of the technological systems has high chance of being effective if nurses can develop a positive attitude about their effectiveness in their duties. According to Moody et al. (2004), factors, for instance, experience with processors were assessed to ascertain there is a link between these features and attitudes towards the system documentation. Moody et al. learnt that fresher nurses and qualified computers operators had a more confident attitude towards the system as compared to older and nurses with little computer knowledge.
Technological modifications in overall can have an impact on nurses’ attitudes and insights. Nurses frequently repel new technological developments centered on the hypothesis that it will interrupt their culture or customary way of executing normal actions (Bozak, 2003). The introduction of automated systems in healthcare facilities will certainly bring about alterations that can make nurses develop an assortment of frames of mind including, for instance, anxiety, nervousness, fury, dislike, misperception, among others (Bozak, 2003), which can make them repel the evolution to automated documentation.
Other barriers that may obstruct the fruitful application of my hypothetical nursing informatics system have been include; the expenditures of electronic systems, deficiency of groundwork to support the new system, reception of new, time to be used in effectively equipping and delivering continuing methodological maintenance for workforce and issues with computer apparatus (Whittaker et al., 2009). Lewin’s hypothetical structure is noteworthy in addressing these obstacles that nurses encounter.
Lewin’s Theoretical Framework
Kurt Lewin’s ideal of change provides a planned methodology that can assist nurses recognize the necessity for transformation, circumnavigate through the change procedure, and accomplish an expected objective (Bozak, 2003). Lewin’s method of change management is significant for health care facilities and organizations that deliberately plan changes in an effort to fit in the current health care needs. The model can also help the nurses in exploring the change procedure and in recognizing aspects that back up or repel the transformation (Bozak, 2003), also called driving or limiting forces. The driving forces enhance change and help organizations attaining the desired objectives while restraining forces that thwart the driving force and inhibit the transformation from taking place. When the two forces are equal, a state of equilibrium is reached. For a change to take place, the state of equilibrium must be interrupted (Kaminski, 2011), which happens when the driving force and restraining forces are not equal.
Lewin’s theory entails three phases, unfreezing, moving, and refreezing necessity for change and arrange for the change to take place. This phase time and again induces a change in the conducts among persons. According to Bozak (2003), emotional state of distress, trepidation, and anguish are likely to be experienced in this period. For one to be able to move to the next phase, it is significant to go through this phase. Nurse informaticists should identify and sufficiently handle these conducts and other repelling forces. Furthermore, the nurse informatics must examine the motivating factors and ascertain if they are stronger than the restrictive forces. Enlightening the nurses about the drives for change can also improve the motivation of the forces and expedite the shift from the initial to the next phase according to Lewin’s model.
The subsequent phase of the change process referred to as moving (Kaminski, 2011). During this phase, change management approaches are focused on solidifying motivating change forces or abating limiting forces that are met in an organization setting. Furthermore, strategies need to be put in place to inspire persons that the anticipated change will have constructive organizational transformation. Those who appreciate the positives outcomes will likely support the projected change and take part in actions that steer it ahead (Bozak 2003).
The last phase according to the model is refreezing. In this phase, the equilibrium has is effectively reached. Consequently, change is assimilated into the normal processes and undertakings in an organization or setting. To stop individuals from reverting to customary states, it is important to endlessly uphold and reassess the change created (Bozak, 2003), which can be attained by use of helpful tools, for instance, strategies, recompenses and learning sessions.
Application of Lewin’s to Nursing
The first step according to the model entails unfreezing to transformation. In order to fulfill this phase, it is obligatory for the nurses to ascertain and rank the motivating and limiting forces. The is attained through getting information through thinking and work in partnership with nursing coworkers. Moreover, participation be sought from other health care experts, since all the professionals in a facility is expected to be affected by the change. When all these factors have been ascertained, the nurse should go ahead and establish a strategy to fortify the driving forces and abate the limiting factors. It is significant for the nurse to uphold an open interaction with the other nursing workforce and incorporate them in all the phases (Noah, 2011).
The second phase entails implementing the transformation. As the nurse continues to interact with his colleagues in a healthcare facility and recognize their submissions and sentiments, the nurse informaticist also needs to assist other personnel to identify importance of automated documentation. Employees will be in position support and adopt change when they acknowledge the importance of electronic documentation be part of the implementation process. The nurse informaticist need to carry on monitoring the other staff change in approaches and performances in this phase. Certainly, the execution of the computerized documentation will upset the customary activities in workflow, which can attract undesirable sensation or conducts among employees.
At this point, the healthcare facility will be using the automated system systems to document patient data. The refreezing entails the period for stabilizing and reassessing the transformation to programmed documentation. The nurse informaticist can preserve this change by supporting the employees through continuing learning. Moreover, the resources must be put in place that will be used to support the nurse, in case they pull out from the new system. It is significant to have information experts ready all the time to offer need also to be ready to help the nurses through provision of inclusive preparation training of new employees. The guidelines should be accessible to help the nursing employees in the documentation development. It is also significant to have constant assessment, which is paramount in ascertaining the new system of documentation is successful and meets its objectives.
Conclusion
Change generally takes place within healthcare setting. Technological developments considerably impact on these transformations and help nurses in meeting their objectives. The evolution from paper to computerized documentation, particularly, provides a solution to the challenges and barriers nurses encounter. This also and assist nurses to address the compound health care needs. Even though this change is obligatory, the application of automated documentation can also have barriers for the nurses. The application of Kurt Lewin’s Change Management mode offers a designed structure that can assist nurses to address these challenges and other barriers that obstruct the conversion process. This paper has presented a research using Kurt Lewis model of management to show how it can be applied in execution of the automated system. This is significant in helping nurses attain their objectives in their healthcare facilities and enrich the quality of nursing care. The theoretical framework can also be applied in assisting nurse informaticists in managing the change process effectively implement the automated system in documentation.
References
Association of Registered Nurses of Newfoundland and Labrador. (2010). Documentation standards for registered nurses. St. John’s: Author.
Bozak, M. G. (2003). Using Lewin’s force field analysis in implementing a nursing information system. CIN: Computers, Informatics, Nursing, 21(2), 80-85.
Kelley, T., F., Brandon, D., H., & Docherty, S., L. (2011). Electronic nursing documentation as a strategy to improve quality of patient care. Journal of Nursing Scholarship, 43(2), 154-162.
Menke, J. A., Broner, C. W., Campbell, D. Y., McKissick, M. Y., & Edwards-Beckett, J. A. (2001). Computerized clinical documentation system in the pediatric intensive care unit. BMC Medical Informatics and Decision Making, 1, 3-9.
Menke, J. A., Broner, C. W., Campbell, D. Y., McKissick, M. Y., & Edwards-Beckett, J. A. (2001). Computerized clinical documentation system in the pediatric intensive care unit. BMC Medical Informatics and Decision Making, 1, 3-9.
MuHugh, N. (2004). Improving staff member satisfaction and productivity through technology. AORN, 80(3), 523-526.
Pfortmiller, D., T., Mustain, J., M., Lowry, L., W., & Wilhoit, K., W. (2011). Preparing for organizational change: Project: SAFETYfirst. CIN: Computers, Informatics, Nursing, 29, TC68-74.
Poissant, L., Pereira, J., Tamblyn, R., & Kawasumi, Y. (2005). The impact of electronic health records on time efficiency of physicians and nurses: A systematic review. JAMIA: Journal of the American Medical Informatics Association, 12(5), 505-516.
Ross-Kerr, J. C. (2003). Computer technology in nursing practice and research. In J. C. Ross-Kerr, & M. J. Wood (Eds.), Canadian nursing: Issues and perspectives (pp. 269-279). Toronto, ON: Mosby.
Yee, T., Needleman, J., Pearson, M., Parkerton, P., Parkerton, M., & Wolstein, J. (2012). The influence of integrated electronic medical records and computerized nursing notes on nurses’ time spent in documentation. CIN: Computers, Informatics, Nursing, 30(6), 287-292.