Nursing review calls for technology use
02 Mar 2010
The Prime Minister’s Commission on the Future of Nursing and Midwifery in England has called for a high level group to be established to help nurses and midwives understand and make use of new technology.
The report, published today, details 20 recommendations, which include an “urgent investment in the development and supply of information systems to front-line staff.”
Its main recommendations are for nurses to be put "centre stage" in the NHS, for ward sisters and charge nurses to be given a stronger role, for the title 'nurse' to be given more protection and for nursing assistants to be regulated.
However, it also saysprofessions must embrace technology in order to deal with the “carequake” of the ageing population.
The report states: “A high level group must be established to determine how to build nursing and midwifery capacity to understand and influence the development and use of new technologies.”
It says that part of this group’s role must be to consider how both pre and post-registration education could best deliver technological understanding.
The report also says that: “Starting in their initial education, nurses and midwives need a better understanding of and influence over the development of technologies and informatics, including information and communications technology and remote care.”
It adds that standarised terminologies and technological advances are increasingly important to provide remote care approaches in telenursing. And it commends NHS Direct for demonstrating what can be achieved in nurse led services.
The report, which has been published following an extensive engagement exercise with the public, service users, staff and other stakeholders highlights the importance of nurses and midwives being appointed as champions of change.
It says that they should be leaders of transformational peer review teams that raise standards and embed innovation and excellence.
It adds that “innovation fellows” should be appointed to lead transformational teams to visit wards, teams, and organisations to help them tackle poor care and embed innovation.
The Commission commented: “We want a future where patients, relatives and careers are at the centre of service development and design, and compassionate care is delivered by technically competent nurses and midwives who maintain a person’s dignity. This is the key to a positive experience for service users.”
Link: Front line care. Report by the Prime Minister’s Commission on the future of nursing and midwifery in England.
Sarah Bruce
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1 The solutions are there: For curious mindsstuart.miller@eclipsys.com 02 Mar 10 17:16 There is a decent track record of nursing and other disciplines collaborating effectively using clinical information systems to change practice and deliver better care. In 2008 Abington Memorial Hospital in Philadelphia, PA won the national MAGNET award for their use of the Daily Care Plan which was handed (out on paper) to patients daily from the information available in their clinical information system. You can read more about their work here: http://www.amh.org/forthemedia/2008/daily-care-plan.aspx Beyond this specific award Abington, a 570 bed facility, has fully deployed an integrated, interdisciplinary, evidence based clinical practice guideline based documentation solution that allows all disciplines to collaborate in the care of the patient. They have advanced documentation deployed for all of nursing (and therapies) across all their inpatient areas. These solutions are available, but what is required is desire, clinical leadership that 'get's it' and 'gumption' from clinical staff to embrace them. I have seen the same tools minus the commitment struggle so its not a technology thing. It is a people and organisational leadership thing. 2 Nursing could demand and benefit far more from good ITjohn.aird@uhl-tr.nhs.uk 03 Mar 10 11:32 NHS nursing has played with IT many times in the past, but probably still don’t take lead in demanding its use or potential. I well recall the NHS funded Nurse IT initiatives of late 90’s (Nurse Dependency, Rostering and Care Management, etc), also numerous patient care and outcome initiatives since, I wonder how many survive today. The relationship of nursing and IT (at least on the ward) goes back to the introduction of PAS and the question of who should update PAS with patient ADT data, where many said “not a nurses job” and by so doing, denied hospitals accurate real-time bed-state data for years. I have some sympathy for their reluctance to use PAS on the ward, historically it did little for them, added to nurse workload pressure and fast ADT would only make available beds visible sooner. However, times are changing and PAS now supports nursing far more than before, eg: bar coded wristbands, discharge letters, order/reporting, ward bed whiteboards. Also hospital management accepts that real-time bed state and PAS bed management functions such estimated date of discharge and support for order/comms can substantially help improve bed efficiency and the financial position. The previous writer talked about clinical advantages to nursing of a good EPR. Quite so, once PAS is genuinely real-time, supporting a good EPR, one can introduce patient care pathways, where on admission a care pathway is selected/written on the EPR. This can automatically set up all the investigation, procedure and discharge ordering, based on an agreed treatment pathway. Along the way Nurse and Clinician checkpoints of patient progress, monitoring and adjustment to treatment and plan modify the care pathway and provide appropriate notation. All this shortens the patient stay through reduction of wasted time (days even), smarter discharge, reduced duplication or inappropriate investigations, etc. IT and EPR systems have the potential to offer nursing far more than rostering and quality/patient satisfaction systems, but if not visioned and implemented to be full integrated care pathway systems, if not leading service redesign, they offer little to nursing for their effort in data entry.
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