The field of nursing provides a wide range and variety of opportunities for an individual, with each
expression of nursing providing a different way of interacting and engaging with technology.
Within my health system there are quite a wide range of roles and positions across the continuum
of care.
Frontline nursing: e e Bedside nurses on the units and departments who utilize the medical record to
help track the care provided and aide in the communication of information important to patient
care. e Processes like automation of input of vital sign data can help save time and ensure that
numbers are more accurately recorded within the medical record. e At my current hospital a
frequent complaint is the lack of automation on these processes, and the requirement of having to
input vital sign data manually is another opportunity for incorrect data input that could have
adverse consequences on our patients.
Nurse Case Managers: e we have case managers from both a nursing and social work background
who have a focus on helping with patient flow and through put; technology systems such as
Ventus have been implemented at interdisciplinary team meetings to help identify barriers to
discharge and help ensure that the right resources are brought to bear in an efficient manner. e
QVENTUS uses logarithms and pulls data from the electronic medical records to try to highlight
possible discharge barriers that might contribute to an increased length of stay. e These might
include insurance barriers, family dynamics, tests that still need to be run, etc.
Quality Compliance Nurses: e Nurses within our quality and infection prevention teams rely on the
electronic medical records to run reports on quality outcomes and utilize safety reporting systems
like "safe care" to understand and track events and identify trends within the hospitals. e Safe care
is a reporting system that any employee can report (even anonymously) concerning specific events
or incidents that occur. e It holds managers accountable as they are required to follow up on these
incidents and report out on findings. e Quality nursing leaders and others can review and access
trends and track other quality data. e (Lowey, 2017). e e
Nursing navigators: e we have nurse navigators who follow up with patients who have specific
diseases and provide specialized support and information. e Access to medical records is critical for
identifying specific patients who would benefit from interventions and to follow up with them. e
Nurse navigators will follow up with patients following discharge and establish follow up
appointments to reduce the chances of readmission and to ensure that patients have the
resources and information necessary to follow up with care plan. e
Informatic nursing: e Informatic nursing involves nurses who serve as a bridge between the frontline
care givers and those more deeply involved in the design and implementation of electronic medical
records. e Their functional knowledge of patient care and understanding workflows is helpful in
providing feedback in the design and implementation of electronic medical records. These nurses
may be involved with developing processes and education around the implementation of EMRs
(Lowey, 2017). e
I currently work as an authorization specialist at a cancer hospital. My team works on obtaining
authorizations for patients with scheduled radiology services. When insurance companies deny a
scan, they typically provide an option for the ordering provider to conduct a peer 2 peer review. A
peer 2 peer review gives an ordering provider an opportunity to present more information
describing why the scan in question is medically necessary. My hospital designates a separate team
of advanced practice providers (APP) to make these calls and conduct peer 2 peers.
My team communicates with the APP team to dispense relevant information for each patient and
the APP returns to my team to report the outcome of the peer 2 peer. e When APP's call for a peer
2 peer, they speak with a Nurse or Doctor employed by the insurance company. My hospital uses
APP's that see patients in a clinical setting for half of their time and then for the other half they
work on peer 2 peers.
Most APPs in clinics use technology to screen and care for patients physically. They also use
electronic medical record systems to write consult notes and record progress for each patient.
APPs employed by an insurance company typically worked with patients physically, but currently
use their medical knowledge to help decipher which course of treatments are medically necessary
for a patient's plan of care from the insurance company's perspective. They typically use
technology to evaluate information presented by a provider's APP and record the final
determination after a peer 2 peer has been completed.
This varying spectrum of roles and functions affects the management of information by requiring
different skill sets from each Advanced practice provider. APPs employed by an insurance company
require less emphasis on bedside manner, and more focus on practical knowledge. An APP working
in a clinical setting must have an excellent bedside manner and must be proficient with all medical
technology.
“The use of information technologies is essential in the daily work of nurses in the health care
process” (Cvetkovic-Jovanovic, 2020). e In my experience, nurses only have the appropriate amount
of access they will need for their everyday workload. e Because of HIPPA, health care workers are
not allowed to investigate a person’s chart that is either not in their unit or not in charge of it.
But of course, there is always an exception to every rule. e For example: a nurse in risk
management has more access than a nurse in the oncology department. e And a nurse that works
at a doctor’s office does not need access to every patient in the hospital. e With that said, it is
inappropriate for a nurse (or anyone in healthcare) to look up and see how a family member or
friend is doing. e
Since I work in a lab, nurses often treat us like IT support when ordering tests or blood products
for their patients. e And as much as we try to help, every department has a different field on how
to order a test or how to administer a blood product. e I wish that some nursing floors could have a
more universal way to access lab results and ordering, or at least given the proper training. e I
believe that this little improvement could improve patient care. e Another thing that I have noticed
is that a nurse in labour and delivery cannot scan documents into a patient’s chart, but a nurse in
the trauma room has full access to scan all documents. e This can affect the management of
information because of human error. e If a nurse is busy helping their patients, it is possible for
them to forget to send medical records and the proper documentation that needs to be in a
patient’s chart. e An example of this is when a patient signs consent to either have a procedure
done or if they are signing consent to receive donated blood. e e In a hospital setting, everything
must be documented.
Reference
Cvetković-Jovanović, М., Ivanović, S., Trgovčević, S., Kilibarda, T., Stanković, M., & Milutinović, S.
(2020). The Application of Information Technologies in the Process of Nursing Care. Acta Medica
Medianae, 59(1), 164–169. https://doi-org.ezproxy.snhu.edu/10.5633/amm.2020.0125
Lowey, Susan. (2017). Nursing Beyond the Bedside: 60 Non-Hospital Careers in Nursing. Sigma
Theta Tau International.
