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Informatics Project

Kayla Adkins

Delaware Technical Community College

NUR 410 Nursing Informatics

Dr. Wagamon

November 29, 2020

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Informatics Project

Before starting this class, this nurse did not understand exactly what nursing informatics

consisted of, but after completion, this nurse has come to the understanding and importance of

what nursing informatics means. By definition nursing informatics is, informatics applied to

nursing science to manage, process, and analyze nursing data, information, and knowledge to

support the practice of nursing and the delivery of patient care (Nursing Informatics, n.d). With

this being said there are a lot of topics and issues in healthcare that can be impacted by nursing

informatics including staff development. Staff development can include hospital orientation,

continuing education, and even in-service training, all of these topics can also lead to staffing

issues and nurse satisfaction. Informatics plays a crucial role in staff development which can lead

to an increase in patient satisfaction which is one of the main goals at hospitals.

According to Quinn (2017), informatics and technology can save lives, shorten wait

times, and increase patient safety and satisfaction. There are five main reasons that informatics

helps nurses and they are; furthering education, increase in communication, saving lives,

protecting themselves, and increasing efficiency (Quinn, 2017). “Furthering education allows for

resources to provide nurses with quick and easy access to trusted evidence-based information

and education tools. Increased communication allows for healthcare workers to text, email and

instant message instead of paging or calling. Saving lives is included because there is telemetry

that monitors patients' hearts and automatic blood pressure cuffs that are able to give accurate

information in a timely manner. Protecting themselves is included because charting is now done

via electronic health/medical records (EMR/EHR) and can chart in real time, therefore if an

incident occurs a couple months or years down the road you should still be able to answer the

questions accurately like they happened that day. Finally increased efficiency allows for nurses
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to chart faster and easier which allows more time for direct patient care” (Quinn, 2017).

According to the University of Illinois Chicago, one of the primary ways that informatics has

changed nursing practice is through documentation. “The Healthcare Information and

Management Systems Society reported that as the result of electronic charting, nurses are able to

obtain information quickly and efficiently, using the information to improve the daily workflow”

(UIC, n.d).

“The Assistant Professor of Biomedical and Health Information Sciences at the

University of Illinois at Chicago, reported that there are three main challenges that healthcare is

currently facing and one of them are the shortage of doctors and nurses” (UIC, n.d.). “Health

informatics is also an important part of care coordinating nursing. The ability to track staffing,

workflow and communication can help nurses to identify areas where current processes can be

improved. This can also help ensure that staffing levels remain adequate, which is critical for

providing patients with the best possible care (UIC, n.d.). The current nurse-to-patient ratios on

the surgical floor at Peninsula Regional Medical Center are six to one. This is an unsafe ratio that

can lead to unsafe outcomes and a decrease in patient satisfaction. This ratio not only affects the

patients but it all begins with the nurses. If these nurses have a high nurse-to-patient ratio it can

cause them to feel overwhelmed and cause an increase of retention rates for these nurses or even

being exhausted and places the nurses at an increased risk to make an error, such as medication

errors.

Andrews (2004), stated that there are two key ethical issues which are; lack of control

over practice and the potential for harm to patients and nurses. He also stated, “These findings

point out the need to not only make improvements in the clinical environment, but also to

address the continuing professional development of the nurse to ensure that nurses will have the
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necessary skills to practice in that environment” (Andrews, 2004). The most important piece of

nursing is the end purpose which is the well-being of other people. “Ethics in healthcare must

start with practice-based understanding of what it is to be a person” (Andrews, 2004). Through

staff development such as continuing education, nurses considered the ethical skills of advocacy

as central to their concept of themselves which they learned how to best apply this still in a

different context (Andrews, 2004).

The nursing code of ethics includes four main ideas; autonomy, beneficence, justice, and

non-maleficence. Autonomy plays a crucial role in nursing because it allows for each patient to

have a voice in their own care. As nurses it is important that we support our patients in their

medical decisions and continue to advocate for them whether we fully support their decision or

not. Justice is another important piece of nursing because it creates a fairness for all patients no

matter their race, religion, ethical beliefs, gender, or sexual orientation. Andrews (2004) stated,

“The most frequently experienced ethical dilemmas were protecting patients’ rights and human

dignity; respecting or not respecting informed consents; providing care with possible risk to the

nurse’s health; and staffing patterns that limit patient access to nursing care”.

Some of these dilemmas such as protecting patient dignity can be easier accessible due to

an improvement in the technology, especially the changes that have been made over the past few

years. The electronic charting and medical records can pose a greater threat for violating HIPPA

and putting patient information into the hands of the wrong people. Andrews (2004) stated,

“With the continuing education that nurses receive through schooling and hospital required

classes, it can help with identifying ethical issues and responding to them based on an

understanding of the principles of ethical decision making. Also gaining confidence through

work with mentors in a supportive environment was essential to successful use of advocacy
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skill”.

Overall, the main issue that seems to be at bay is the lack of staffing. This issue is not

only something that occurs around this area, but it’s a nationwide issue. It’s times like now that

hospitals need to make sure they have the staffing especially due to this pandemic that is

currently happening. There is an influx of cases but no nurses to take care of them. Again, this

staffing issue leads to nurses leaving their job months after their start date because they feel

overwhelmed and coming to work would put their patients at risk for complications or neglect of

care. At the same time, those nurses not showing up to work also puts these patients at risk

because the nurse-to-patient ratio will be six to one. This situation is again something that the

most of the floors at Peninsula Regional Medical Center are having issues with, and the nurses

that work there have expressed multiple times their feelings in hopes that things will change

soon.

With a ratio such as this, nurses are at a greater risk for putting a delay in patient care

because they must do total care for six patients and, sometimes there will be a few patients who

are dependent and require more attention, therefore the other few patients will not get the

attention that those dependent patients get. This ratio can also cause the nurses to not be able to

complete an assessment on time because of those reasons stated above. The other most important

issue that can occur because of lack of staffing is a delay in medication administration. If patient

outcomes have been altered because of nursing care, the provider needs to be notified so they can

make any necessary changes then the plan of care can be resumed. If there were no changes in

the patient outcome because of delay in care then just resume the patient’s current plan of care.

Creating a workflow map would provide a better picture for the hospital regarding patient

outcomes due to the lack of staffing.

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In order to see a difference in the staffing issue hospitals need to come up with some

interventions including, decreasing nurse-to-patient ratios to four or five to one in order to

provide better outcomes for nurses and patients. If this was the ratio in hospitals, there would

hardly be any delay in patient care because the nurses would be able to spend more time with

their patients and be able to provide them with the proper care that they need to thrive.

Assessments could be completed in a timely manner and this could help with an increase in

patient care because the doctors usually round in the early mornings, and if nurses already have

their assessment complete you would be able to update them on their status. Finally, medications

would be given on time which can be very critical especially for the patients that receive heart

medications such as aspirin, plavix, or amiodarone. Another important piece of decreased nurse-

to-patient ratios are the more time nurses spend with their patients it’s more than likely to

decrease their length of stay. Having these extra hands can make nurses not feel as overwhelmed

and can in turn lead to nurses having a happier life and feeling less stressed. Patient outcomes

and patient satisfaction are improved due to the fact that the ratio is lower so nurses are able to

spend more time with their patients.

Informatics played a huge role in making this workflow map because it took analyzing

data from a local hospital and the knowledge from other nurses to come to the final conclusion

that there is an issue locally and nationwide on nursing shortage and unsafe nursing ratios. If a

workflow map was made and placed in front of nurses and other healthcare staff, they would be

more than likely to retain that information rather than, if they were to read an article on the

effects of unsafe nursing ratios. Hiring more nurses will not make the hospitals more money to

begin with but hopefully those nurses will be able to keep re-admissions down and will in turn

make up for the new nurses.

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A policy that this nurse would like to trial after completing the workflow is adding a

nurse on the floor from eleven in the morning till eleven at night. This nurse believes the addition

of this nurse would be able to help with admissions, discharges, and medication administration,

which tend to take the most time out of the day for the nurses to complete, especially if the

nurse-to-patient ratio is still six to one. In addition to this nurse, it would be ideal if each nurse

could only have four or five patients to allow for more time with one another and to allow for

improved patient outcomes. Overall, the unsafe nurse-to-patient ratio has to do with the nursing

shortage and no matter how hard hospitals try there may not ever be a way to solve this

everlasting issue. Either way something has to be done to help the nurses improve patient

satisfaction and outcomes and also something to help nurses not become so overwhelmed as

easily.
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References

Andrews, D. R. (2004). Fostering Ethical Competency: An Ongoing Staff Development

Process That Encourages Professional Growth and Staff Satisfaction. The Journal of

Continuing Education in Nursing, 35(1), 27-33. doi:10.3928/0022-0124-20040101-10

Informatics in Nursing: Impact and Importance: UIC Online. (2020, July 20). Retrieved from

https://healthinformatics.uic.edu/blog/the-impact-of-health-informatics-on-nursing-

practice/

Nursing Informatics. (n.d). Medical Dictionary for the Health Professions and Nursing.

(2012). Retrieved from https://medical-

dictionary.thefreedictionary.com/nursing+informatics

Quinn, J. (2017, September 13). Five Ways Healthcare Informatics Help Nurses. Retrieved from

https://health.ebsco.com/blog/article/five-way-healthcare-informatics-help-nurses