The nursing profession is changing – in large part fueled by information technology that can help nurses meet a growing list of challenges, said Summer Blackerby, RN, chief nursing information officer at CoxHealth Hospital in Springfield, Missouri.

Blackerby knows what it is like being a nurse today and the challenges nurses face on a daily basis. She also is intimately familiar with the state of nursing informatics today – how it is helping and where it needs to improve.

Further, she knows why and how hospitals and health systems should adopt technology that enables nurses to provide care beyond the bedside. Not to mention technology that streamlines nursing workflows.

And on another front, she understands the importance of nursing IT in enabling personalized care.

We did a deep dive interview with Blackerby to discuss all of these subjects and share her expertise with readers.

Q. What is it like being a nurse today? What are the challenges you face on a daily basis? Where are you looking for help?

A. I think it goes without saying that nursing is more complex today than ever before. However, I also believe it is still one of the most rewarding professions. We are caring for an aging patient population with complex diseases or comorbidities, coupled with the ongoing shortage of clinicians, which contributes to challenges in retaining and attracting more clinicians to the bedside.

As a result, you see health systems seeking solutions to assist with more time-consuming tasks such as documentation, education, and anything that provides the opportunity to put the clinician back at the bedside delivering hands-on care. While the tasks are important and necessary, there are equally as effective methods to complete the task and provide more time back to the bedside care team.

Another challenge nurses are facing is information overload and alarm fatigue. As technology has increased within the care environment, it has reached a pinnacle where teams are now overloaded with alarms, which has resulted in alarm fatigue and desensitization.

We have to rethink how we equip our nurses and clinicians with the right technology to balance a highly technical environment with human-centered and focused care delivery. Implementing technology that effectively synthesizes data and presents it to the clinician to accelerate care interventions is key to mitigating information overload and ensuring priority alerts are acknowledged.

This is foundational to creating a safer environment of care and delivering the best patient care possible.

To combat this, nurses need access to technologies that focus on all aspects of care and improve the functionality of the care team. This need is not limited to just acute care, it is a consistent need across the care continuum. Using modern-day technology to increase nursing productivity and redesign care models to overcome some of these challenges is essential.

Telehealth and in-hospital remote monitoring systems play an important role in redistributing the care load across team members allowing bedside nurses the ability to focus on hands-on care while other virtual care team members complete tasks that do not require presence at the bedside. These tools also enable care standardization across the spectrum as a dedicated team becomes highly skilled at alarm management and focused on virtual care workflows.

At CoxHealth, our strategic focus over the past two years on in-hospital telehealth capabilities, like eICU and eAcute, is already having a profound impact and is supporting our vision of transforming care delivery. The impacts are being demonstrated by improvements in our patient outcomes and also demonstrated in our staff satisfaction. As more health systems implement similar technologies into their workflows, we'll continue to see the positive impact.

Q. What is the state of nursing informatics today? How is it helping? Where does it need to improve?

A. I have been fortunate to have been in the field of nursing informatics for more than 15 years. I will openly admit that when I stumbled into healthcare technology, it was still unusual to have nurses working in the IT department. Over the years we have made significant strides, but we still have much work to do.

Our profession is more widely accepted but we need to be more present in many conversations that occur across the various levels of healthcare. I often say, "When in doubt, include the nursing informatics team." We are there to support and identify where technology can improve workflows, eliminate steps by streamlining applications, or remove manual work by implementing new technologies.

Technology has certainly changed how we practice nursing and deliver patient care. I am optimistic about the future and how health technology and virtual care models will support nurses by leveraging advancements in AI capabilities and the potential to automate routine tasks that are often burdensome.

Overall, it is still difficult to synthesize the surplus of data, especially for patients with complex diseases. Despite a higher volume of patient data generated by patient monitors and other medical devices, it is often presented to care teams in siloed formats.

Designing systems that integrate data into the clinical workflow in a meaningful way continues to be a focus. A recent example is a solution we implemented that aggregates data from disparate medical devices and presents the data on a dashboard used by a multidisciplinary team.

This has enabled our care teams to collaborate in a way that was previously unavailable, and this has strengthened the collaboration between our RT, early intervention, provider and nursing teams. Presenting information in a holistic fashion is critical to enable all nurses to make clinical decisions in an efficient and fully informed manner.

When this is not done well, it adds time onto nurses' plates and can also impact patient care. This can also make it difficult for cross-disciplinary care teams to collaborate on a treatment decision, which could ultimately impact the level of personalized care a patient receives.

Q. Why should hospitals and health systems adopt technology that enables nurses to provide care beyond the bedside?

A. Care delivery models are changing. Technology continues to support the delivery of increasingly complex care outside of traditional care settings. Patients' willingness to adopt technology in many other areas of their life also serves as an accelerant to how they want to use technology to interact with their healthcare teams.

We must meet our patients where they are and provide more options for them to balance their health and wellness with the demands of life.

Knowing that nurses remain the main point of contact for patients receiving at-home care, we need to ensure access to seamless technologies and resources that help them communicate with patients and help guide them on the care journey.

Effectively engaging the care team outside of the hospital to facilitate earlier care interventions, as well as guide patients to the appropriate level of care, ensures only those who require in-person care are seeking treatment. Leveraging virtual care technology can create efficiencies within hospitals, such as freeing up space, reducing wait times, and lessening administrative work nurses must complete before and after appointments.

Nurse informaticists bring expertise in the design, deployment and adoption of technology and play a vital role in ensuring nurses remain familiar with emerging forms of technology.

Q. Why should provider organizations adopt technology that streamlines nursing workflows?

A. I have personally experienced the impact that technology can have on nursing workflows, and in general, the impacts are usually positive. However, I have also experienced technology deployments that have not improved the care delivery process. Informatics plays an important role in assessing and identifying how technology will truly integrate into the clinician's workflow, versus become something that is yet another task for them to tend to.

A recent example of tech utilization is our virtual care program that I referenced earlier. This project involved frontline clinicians from the inception of the pilot and through all design and implementation phases. As a result, it has been one of the more transformative projects in the acute nursing space.

While staffing shortages impact the ability to pull frontline clinicians into projects, it is one of the most valuable decisions we have made. We largely attribute the success of this program to our human-centered design approach; it is technology that is enabling the change, but it is our clinicians and nurses leading the change.

Q. What is the importance of nursing IT in enabling personalized care?

A. Personalized care is enabled by informing our nursing and clinical care teams with the right information at the right moment. While that sounds simplistic in nature, it must be fully supported by a robust technology infrastructure that is truly designed with the clinician and patient in mind.

Our medical records are full of data, we must continually challenge ourselves to ensure we are tasking our clinicians with capturing and analyzing data that really drives care. The art and science of personalized care rests upon multiple processes and workflows that inform decisions by taking into account all factors of care for each individualized patient.

Nurses remain closest to our patients and our nursing informatics teams remain close to our nursing teams to advocate and design workflows that support the best care. Leveraging many modalities of technology allows both bedside care teams and virtual care teams to engage in meaningful ways with our patients and their families, ultimately creating an environment where clinicians are fully supported, and patients receive care that is personalized for them.

I am very optimistic about the future of healthcare and how we can continue to leverage technology to transform our care delivery system. The magic is striking the balance of moving forward at the pace the technology is moving while keeping a human-centered and patient-centric focus. The past two years have proved more than ever within our organization that it's possible.

Seeing our nurses and patients respond so positively to our virtual nursing program has refueled my passion to keep seeking solutions to the challenges we face, and I'll restate that I still believe nursing – healthcare – is one of the most rewarding professions that one can belong to. It is meaningful work to be a part of caring for individuals on their healthcare journey.

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