Consider the barriers that have been discussed in previous posts that can occur from when computers, iPhones, iPads, and EHRs are implemented into hospitals and health facilities.- Personal health information being shared--> confidentiality and privacy breached
- Organization and data accuracy
- Nurse accountability and advocacy issues
Theses concerns can be addressed by implementing policies in institutions to create secure, safe, and educative environments.
Policies provide standards and guidelines that help to address issues the are present that take action for effective change. These policies include plans and decisions that provide guiding principles that nurses, physicians and members of institutions are responsible for upholding. Policies are established for a specific goal that enhances a facility and workplace. In the transition in a more technology focused workplace, policies are vital in meeting the needs of consumers and bridging these barriers.
The World Health Organization (WHO) defines an operational and successful policy has having the following characteristics:
1) Defines a vision for the future
- Must have specific, clear goals that address explicit concerns or issues.
2) Outlines priorities and expected roles of different groups/ parties
- Labels what each person is responsbile for, relates to patients, HCPs, institutional officials
3) Builds consensus and informs people
- The public and workers have a common goal and must be informed
At every level there are different types of policies that govern nursing practice.
Institutional --> Policies that apply specific institutions (hospital level)
Municipal-->Policies enforced by a municipality, city or community
Federal--> Applied at federal, provincial level (CNO, RNAO)
National--> Policies enforced by the nation governing body ( CNA)
International--> Global policies that set guidelines (WHO)
There are many policies that are currently present that apply to some of the concerns regarding eHealth, but nurses may have to take a significant role in implementing new change. Creating new policies is a dynamic and cyclical process that depends on on involvement from both the consumer (patient) and the institution (Rochon, 2010).
Nurses must take an active role in recognizing where policies and guidelines are lacking. To formulate policy, specific common goals that unify the community are needed to be addressed. A clear and concise plan must be formed (Lomas, 2007).
The nurses responsibilities to recognize where barriers exist. This involves having a thorough understanding of how technology is working to meet the needs of the health care provider and the patient. When inadequacies arise, nurses need to take initiative to reduce the barrier. For example, when patients find that their perception of illness is missing and being omitted from the EHR, nurses need to work with their eTools and the patient to fill the gaps. Patient-gathered data is an effective way to help address the patient perspective to understand inadequacies (Koliner & Flatley Brennan, 2013).
The next step in policy construction is policy realization, and putting ideas into action. Many nurses are apprehensive in taking charge in their workplace and bringing concerns to the attention of their workplace (Perna, 2013). While this can be overwhelming, nurses should feel empowered to take a stance in their community to advocate for health rights. Nurses should partner with the inter-professional team and work with their patients to find the root of problems and make them known to the appropriate policy level.
For instance, nurses and HCPs should advocate for policies that ensure adequate training regarding technology at the institutional level. By ensuring that technologies are properly used nurses are able to promote health privacy and security, and able to work efficiently. As well, this ensure that there is continuity of care, and that the health care team can work more cohesively via practice permissive policies (Koliner & Flatley Brennan, 2013). . Thus creating a properly trained network of health care providers who all understand the history of the patient. This policy will help meet and reduce barriers before they occur.
Policy learning requires the nurse to evaluate the effectiveness of policies and monitor changes. Once policies have been formulated and introduced to the workplace they need to be evaluated to see if they are meeting the desired goal. The nurse acts as educator by working closely with the patient to evaluate is they understand their rights and access to their personal health information (CNA, 2011).
A policy that may apply is that nurses are responsible in keeping patients updated about their current health status and progress. This may involve showing patients trends and charts about their health that may help the patient recognize own trends in their lifestyle. A diabetic patient who is wanting a better understanding about how their blood glucose fluctuates throughout the day should be given access to this information to increase patient learning. Through policy learning and evaluation, nurses are able to enhance patient learning (Lomas, 2007).
Since nurses work front-line, behind the scenes, and in every governing body level, they need to take action in recognizing inadequacies and potential barriers that exist. As technology becomes ingrained in hospitals, health units and community care, nurses are still the health care professional who works closest with patients. Nurses need to discuss with patients and evaluate their understanding about eHealth and advocate for their learning.
---Student Nurse Katie
References
Canadian Nurses Association. (2011). Nursing informatics: Best nursing. Retrieved from http://www.cna-aiic.ca/en/on-the-issues/best-nursing/nursing-informatics
Lomas, C. (2007). Policy: Nurses' input vital to guideline development. Nursing Times.net. Retrieved from http://www.nursingtimes.net/policy-nurses-input-is-vital-to-guideline-development/304488.article
Perna, G. (2013). HIT voices: The policy challenges facing health IT leaders. Healthcare Informatics. Retrieved from http://www.healthcare-informatics.com/article/hit-voices-policy-challenges-facing-healthcare-it-leaders-part-1
Koliner, S., & Flatley Brennan, P. (2013). Advancing healthcare information technology through policy. CIN: Computers, Informatics, Nursing, 31(5), 205–207. doi: 10.1097/NXN.0b013e318299dc34
Rochon, P. (2010). Institutional financial conflicts of interest policies at Canadian academic health sciences centres: A national survey. Open Medicine. 4(3). Retrieved from http://www.openmedicine.ca/article/view/340/341
Weill Cornell Medical College. (2013). Center for Healthcare Informatics and Policy. Retireved from http://weill.cornell.edu/chip/about-us/
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