Medical science has always embraced advancing technology. And, it continues to do so today, changing nursing practice in ways that would have been unimaginable in the past.
Here are just a few of the ways that technology is being used in nursing:
- Remote monitoring assists in diagnosis, treatment, and monitoring of chronic illnesses.
- Modern diagnostics, analytics, and informatics help keep nurses abreast of local and global health trends.
- Electronic nursing tools ensure timely and effective intervention
- Remote education and training help healthcare professionals stay up to date with advances in science.1Jones, Diana P.; Wolf, Debra M (2010) Shaping the Future of Nursing Education Today Using Distant Education and Technology
It is no wonder that new technologies are guiding more and more of what we do.
Delivery of care evolves with advances in technology
Good nursing practice is based on the provision of timely, evidence-based care including for monitoring, diagnosis, and treatment. This ensures the best possible patient outcomes and experience.
It is important to note, however, that the way this nursing care is actually delivered evolves with advances in technology. Technological advances and resultant changes in day-to-day nursing practice are happening faster than ever, bringing benefits (and occasional problems) to everyone.
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The Internet and the expert patient
This is the information age and there is a lot of it out there. Medical knowledge is no longer the arcane dominion of the professional few.
Everyone now has the ability to easily access information about symptoms, conditions, and medications, and other treatments. There is, in fact, an overwhelming amount of medical information on the Internet.
Some of this information is evidence-based and
up to date but a lot of it is absolutely not.
Nurses with direct patient contact, therefore, have an important new aspect to their role. That is to empower patients to locate and learn from reliable, credible sources.2Finding Credible Medical Information Online. OpenMD. https://openmd.com/guide/finding-credible-medical-sources
Many healthcare professionals are finding that their patients know more than ever about their medical conditions. It is expected that this will continue to increase over time as access to medical information becomes easier and easier.
Many clinicians have found that it can be a very positive experience to work with informed patients and families. This is because it leads to a more equal professional-patient relationship and a more cohesive approach to care and treatment.
Advances in technology are already enabling real-time, remote monitoring and investigations. Here are some examples:
- The Implantable Loop Recorder detects heart rhythm disturbances and can relay information to a central monitoring team. This enables diagnoses and, perhaps in the future, immediate emergency responses.
- Combined continuous blood glucose monitors and insulin delivery systems facilitate optimum diabetes management.
Tracking activity and vital signs has become a part of everyday life for many people. One measure of its popularity is the fact that manufacturers of wearable activity and heart rate trackers. These include Apple, Samsung, and Fitbit, who are reporting huge profits. Fitbit alone has sold more than 76 million devices.3https://www.statista.com/statistics/472591/fitbit-devices-sold/
Home blood tests
Many of the blood tests traditionally processed in labs can now yield almost instant results with just a finger prick at home. For example, in addition to well-known home tests such as blood glucose and pregnancy tests, people can also do home-testing for cholesterol, prothrombin time for blood thinning, hepatitis C, and some drug tests.
The use of these technologies can influence individual diagnoses and treatment plans. It can also show trends and collect demographic data on a scale greater than ever before.
Less time in clinics and fewer admissions
Remote diagnostic tools mean less time in clinics because results clinicians have ready access to results from these monitors. They can then respond to them via virtual consultations by telephone or online.4Powell, J. et al. (2009) ‘Pilot study of a virtual diabetes clinic: satisfaction and usability’, Journal of Telemedicine and Telecare, 15(3), pp. 150–152. doi: 10.1258/jtt.2009.003014.
Remote healthcare will never replace the need for an acute hospital setting. However, with quicker diagnosis and treatment in the community, a reduction in unplanned admissions to hospitals can be expected.
Communication technology in the hospital is changing nursing practice
Electronic clinical observations have been rolled out on a massive scale in hospitals around the world. These can take the form of individual patient monitors, which record and store all data that was traditionally recorded on paper. These include regular blood pressure readings, heart rate, respiration rate, and temperature. This data can be accessed by remote hand-held devices carried by the healthcare team.
With built-in protocols for alerting members of the team when results are out of a set range, the right people can converge on a sick patient in seconds.5Peters M, Moore P (2018) Using quality improvement methodology to implement an electronic pediatric early warning system (PEWS) across Great Ormond Street Children’s Hospital (GOSH) Archives of Disease in Childhood This technology also allows clinicians to prioritize their workload and request assistance from specific services at the push of a button or the tap of a screen.
The use of remote patient monitoring devices in hospitals can mean getting the right help for your patients without even leaving their side.
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Patient safety is always top priority for nurses.
Electronics devices have long been used to improve patient safety. These range from chair sensors to alert staff when a confused or unsteady patient has stood up to wristband barcode scanners to ensure the right medications get to the right patient.
The World Health Organization has long championed the use of emergent technology to improve patient safety 6https://www.who.int/patientsafety/en/brochure_final.pdf For example, electronic reporting of incidents aids in the understanding and prevention both at a local and global demographic level. One study found a 250% decrease in drug errors following the implementation of electronic incident reporting in one hospital.
Is health technology the answer to all our problems?
As always, with such a paradigm shift we are met with bumps along the way. Further, much of the technology we’re using is still in its infancy.
With remote and mobile healthcare, we have a huge increase in the amount of cloud-based and remote data storage of sensitive patient information that is, by necessity, identifiable, accessible, and retrospective.7Dixon J. F. Going Paperless with Custom-Built Web-based Patient Occurrence Reporting. Joint Commission Journal on Quality Improvement. https://www.ncbi.nlm.nih.gov/pubmed/12101550
Privacy is a concern
Legislation exists across the EU8 Health and Social Care, Information Commissioners Office, UK https://ico.org.uk/for-organisations/in-your-sector/health/ and US9Health Information Privacy, U.S. Department of Health & Human Services https://www.hhs.gov/hipaa/index.html in particular, that aims to govern the use of medical records. Governing in a way that balances privacy concerns with the sharing of information necessary to prove high-quality care. A robust system for informing patients and gaining consent for any projected use of their information is essential.
As the public becomes more aware of the cybersecurity and privacy issues faced by organizations that hold large amounts of valuable data, the use of this data will be informed by evolving ethical standards.
Technology and nursing are here to stay
We are undoubtedly in the middle of a technological revolution, nowhere so much as in medicine and nursing. But medical technology is only a tool to make patient care more efficient and effective, to improve safety and speed.
Robots are not going to replace nurses anytime soon.
One potential benefit of new technologies is that they may eventually free up nursing time for more traditional care and patient-centered activity.
Whatever happens, one thing is clear. Technology is poised to change nursing practice into something that would have been unrecognizable by our predecessors.
The good news for nurses is that some things will never change, Patients and families will always need and want a human touch and a good patient experience.
 Peters M, Moore P (2018) Using quality improvement methodology to implement an electronic paediatric early warning system (PEWS) Across great Ormond Street children’s hospital (GOSH) Archives of Disease in Childhood
 Health and Social Care, Information Commissioners Office, UK https://ico.org.uk/for-organisations/in-your-sector/health/