The Impact of Technology in Nursing: Easing Day-to-Day Duties

Benefits of Nursing Informatics

“The biggest technology being used is the one we can’t see,” says Liz Stokes, director of the American Nurses Association Center for Ethics and Human Rights. “It’s algorithms. Many nurse scientists are using predictive algorithms to identify risk in patients.”

Victoria Tiase, director of research science at New York-Presbyterian Hospital and a member of the American Medical Informatics Association board of directors, explains that nurses leverage healthcare data to make changes to their practice. Informaticists ensure that data is being used to support nurses in a variety of activities, while also ensuring that nurse leaders have the data they need to support staffing and other unit needs.

Tiase describes nursing as being in the descriptive analytics stage in which IT teams provide nurses with dashboards and views to surface data.

“It’s just not efficient for bedside nurses to dig through the EHR data. They may be unable to find what they need when they need it to impact patient care,” she says. “We need to move toward predictive and prescriptive analytics so we can get to the point where we’re influencing decision support by providing recommendations about interventions for a particular patient or predicting a patient’s risk for a negative status.”

The most common use of this technology in practice is the surfacing of information to nurses in ICU settings to show if a patient’s health is at risk of deteriorating, according to Tiase. This allows nurses to intervene quickly.

Stokes says predictive analytics also can take data from the EHR to predict readmission for diabetic patients or to identify patients at risk of suicide. The technology also can be used to help patients along their care journey. For example, an algorithm can predict when patients will be ready to be discharged so nurses can prepare for the discharge ahead of time.

New solutions also enable healthcare organizations to capture more data on the social determinants of health. They can use data from personal health records and EHRs to understand when a patient is at risk of being readmitted. If a patient is at risk, the care team can determine how to fashion their discharge to support their care outside of the hospital.

Nurse leaders and managers can use data to ensure effective utilization of the workforce by displaying census data alongside staffing and nursing skill set data to make decisions, says Tiase.

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Nurses Are Responsible for Ensuring Quality Data

Nurses are often the people inputting the data used by predictive analytic algorithms, making them critical to the data quality. It’s their responsibility to ensure data is accurate and unbiased, which makes training an important aspect of a successful analytics program.

Stokes says one thing often missed during implementation is having nurses at the beginning stages.

“The first piece is to have nurses at the infancy stage when creating the algorithm. It’s important for nurses to understand what’s happening,” she says.

One way to facilitate the capture of quality data is by reducing nurses’ documentation burden. This can be done by ensuring necessary devices such as cardiac monitors and other vital sign monitors are interfaced properly with the electronic medical record in a way that complies with appropriate standards. The implementation of voice technology gives nurses the ability to document using speech, which is efficient and hands-free.

“I think, connected to that, is ensuring there are individuals within healthcare organizations and health IT vendor organizations with informatics skills who can help do some of the work to articulate nursing workflows in a way that creates efficiencies,” says Tiase. “Not all nurses are experts in data management. We need individuals to do that work to support nurses on the front line.”

Providing nurses with smartphones or other mobile devices is another way to get data in nurses’ hands. Tiase says that making sure all nurses have access to devices will help them use the technology efficiently.

Robots in Nursing Save Time and Energy

Several types of robots are already being used to assist nurses in their jobs. A new mobile lifting robot can physically assist patients by lifting them from their beds. These robots can be used for transportation or rehabilitation. A nurse or assistant is always in the room to monitor the situation and help the patient feel safe, says Stokes.

Customer service robots, which have grown in popularity amid the pandemic, can greet patients, ask questions for triage purposes and help patients sign in. Some senior care centers have purchased companion robots to keep seniors company and provide comfort because nurses and clinicians can’t be everywhere at once. However, these robots can create some care challenges.

“People can become emotionally connected and reliant on the robot. A senior in trouble or not feeling well may rely on the companion instead of notifying a nurse,” says Stokes. “The robot provides support, but it’s important to make sure the reliance isn’t too heavy. Seniors need to express their needs to a nurse directly.”

Chatbots are another technology assisting patients and nurses. A bot’s algorithm can determine whether a patient’s symptoms warrant a conversation with a nurse. If the symptoms do not require escalation, the bot can handle the conversation, allowing nurses more time to care for critically ill patients.

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Robots in Nursing Take on Fetching Tasks

Diligent Robotics Co-Founder and CEO Andrea Thomaz and Co-Founder and CTO Vivian Chu shadowed nurses and clinicians to identify ways in which robotics could be useful in healthcare settings.

“The thing we learned about nurses when we started shadowing them is that they are so selfless and will do anything for their patients,” says Thomaz. “We would never hear anyone complaining about the lower-level fetching and gathering tasks that fall on their plate. We realized some of those tasks can be automated. “

Diligent’s Moxi robot can handle point-to-point deliveries, saving nurses from spending time away from patients because they must run to a lab, pharmacy or supply closet.

To implement Moxi into a healthcare organization’s workflow, Diligent’s team gives the robot a facility tour, showing it any location within the environment that it may need to access and pinning the important ones. The lidar sensors needed for mapping are self-contained, and Moxi uses cloud-based AI software; no onsite server is necessary. The robot requires a Wi-Fi connection, but also has an LTE cellular backup. The healthcare team can interface with Moxi using a tablet or mobile device.

“We’re just scratching the surface in terms of the kind of automation and help robots can provide,” says Thomaz. “We’re looking at different software integrations to EHRs and other nursing communication devices.”

A shortage of highly skilled staff makes robotics and automation a valuable tool for healthcare organizations.

“Organizations want to show nurses that they value their time, and they want nurses to be focused on patient care,” says Thomaz. “Robots don’t take care of people; people take care of people. We’re never going to be taking the core function of what it means to be a nurse. We’re just helping them spend more time on taking care of people.”

Another benefit of this type of technology is the potential to improve consistency across the care spectrum. Thomaz explains that every patient that comes in and has a particular condition will likely need to be treated with a specific set of supplies or equipment at the same time with respect to their arrival.

“We can start to automate these care protocols, and then you’re going to get more consistent and reliable care to everyone,” she says.