Resistance to Information Technology in Nursing

• Change is met with adversity against those who hang on to the way things “used to be.”
• Change has introduced techology in nursing such as the stethoscope, advanced EMR systems, and medical devices.
• Change can be scary, but if done correctly, can automate healthcare practices to render more and better patient outcomes.

Change is inevitable. It is a part of our everyday life. From life and relationships to the weather and culture.  With today’s ever changing, fast-paced world, transformation is taking place in every aspect of our lives. 

Many individuals fight to hang on to the way things “used to be done”, and others embrace change with anticipation and excitement.   

Change is even seen within healthcare. Nurses are working longer into their careers, and due to this there seems to be more hesitation among individuals to accept transition and change. 

As expected, the older generation nurses may resist change more despite research substantiating the need for certain healthcare practices to evolve.   

One may ask how an organization facilitates positive change.  The main factor is to include staff members in the decision-making process and to encourage that change is not always negative. 

Change can be viewed as an opportunity for great achievements, and if presented as a familiar process, it can serve as a positive factor for each organization.  Staff can be empowered to embrace these changes with confidence and eagerness to learn a new skill or policy that may enhance patient outcomes.   

An outstanding example of this would be the introduction of the stethoscope in the 1800’s. The stethoscope was met with great resistance among clinicians, who thought it was invasive and contrary to current practice.

It is a tool that has become integrated in clinical practice.  Today, there are few physicians that could imagine administering care without the assistance of a stethoscope.  

Similarly, health information technology (HIT) has met the same resistance among some healthcare professionals that is changing the skills and behaviors required to function effectively in an organization.  

Impact of Information Technology in Nursing

The advantages of applying information technology in nursing indicate that competency in nursing informatics is a prerequisite to improving patient care.   

The areas that seem to have the greatest impact on nursing and healthcare include improved documentation, reduced medical errors, reduced costs, and improved coordination of care.   

With documentation being such a necessary component of nursing, advanced information technology has allowed patients’ medical history, needs, and medical conditions to be shared electronically. This shared information has improved quality of care for patients.   

With electronic documentation, nurses can make better decisions about how to provide care and when changes or adjustments need to be made by examining the documentation of a patient’s condition over a period of time.  

These improvements in quality care are due to a reduction in medical errors, healthcare costs, and improved coordination of care. 

Reduced Medical Errors  

• decreased number of medication errors, misdiagnoses, falls, and other problems have been noted   
• electronic records can provide information about a possible medication interaction that may not be apparent immediately 
• an increased knowledge base due to electronic records and quick access allows nurses to make appropriate decisions that maintain the safety of their patients 

Reduced Costs in Nursing  

• health care is more manageable due to information technology  
• provides nurses with alerts to avoid certain errors and helps to automate certain tasks by improving both nurse productivity and preventing some of the associated costs of health care 
• medical errors can cost billions of dollars annually, but implementing the use of nursing informatics can help reduce these costs dramatically  
• a reduction in medical errors results in patients’ lives being saved, allowing the care received to be delivered in a professional and meticulous way due to nursing informatics   

Improved Coordination of Care  

• many team members have access to information that needs to be relayed, shared, and communicated both during care and at discharge    
• nurses are able to provide and access this information in a timely manner which assists in improving both patient outcomes and satisfaction of patient care   

Regulatory Agencies and Information Technology

Legislation plays a part in governing the flow and exchange of electronic health information that enhances usability, accessibility, and privacy among patients, health care staff, and families.  

The main ones that serve an integral part of this process include Health Information Technology for Economic and Clinical Health (HITECH Act) which allows programs to be established that increase health care promotion by including health information technology.   

The Food and Drug Administration Safety and Innovation Act (FDASIA) also uses a regulatory framework for health information technology.   

In addition to the above, the Health and Insurance Portability and Accountability Act (HIPAA) is an important part of the informatics process which sets standards for transactions involving electronic health care and managing privacy.   

Each of these regulatory agencies serves an important part in nursing informatics and the increasing use of health information technology in nursing. 

Causes of Resistance Against Technology in Nursing

What causes all the resistance?  The concept of user resistance has been a common theme and researchers have sought to explain the reasoning of resistance and how it takes place.  The most prominent phenomenon identifies five key concepts that serve as setbacks to implementation of information technology in nursing.   

Five key concepts of user resistance:   

• the object or technological aspect being implemented 
• subjects of resistance 
• initial conditions 
• perceived threats 
• manifestations of resistance 

The object of resistance can include the system itself, its effects, and the ones who implement the system. 

The subjects of resistance can be described as those exhibiting resistant behaviors such as individuals, a group, or an organization. 

The initial conditions refer to the characteristics of the environment such as the user’s attitude toward the system based on prior success or failure of the system or one that is similar to the current system. 

Perceived threats consist of negative assessments that users portray based on the implementation of technology in their organization. 

Manifestations of resistance and is defined by a set of behaviors carried out by certain users to display difficulty with the new information technology system.   

Some argue that nursing informatics devalues the patient and offers less than optimum nursing care, however the majority debates nursing informatics leads to overall improvements in patient outcomes.  Nursing professionals can accelerate this process by recognizing the need to adapt in a technology-enabled environment. 

The Bottom Line

Implementation of information technology has been met with adversity. Nursing informatics can support and lead this transformation by being proactive and creating the educational models and leadership development programs necessary to ensure that nurses have competency to address emerging technologies.   

It is imperative that nurses serve in the forefront of planning and preparing for these challenges for nursing informatics to be implemented effectively and to render positive outcomes. 

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