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Nurses want to use IT, but are held back by barriers

A majority of nurses welcome digital technology, but costs, poor connectivity and a lack of interoperability act as barriers, and lead community nurses to use paper instead

The uptake of digital technologies in nursing – particularly among those working in community settings – is held back by a lack of connectivity and incompatible IT systems, according to the Queen’s Nursing Institute. 

The institute’s report on nursing in a digital age is based on a survey of more than 500 community nurses, and found that while most are positive towards digital, there are still huge barriers in place.  

One key issue is the lack of interoperability, which is not limited to community settings, but widespread across the NHS.

Nearly one-third (23.7%) of those surveyed see systems’ “inability to talk to each other” as one of the biggest challenges, and the report said there are more than 67 different systems in use in community healthcare.

Lack of interoperability also leads to lack of information sharing. Despite the fact that they should have access to GP records, the report found less than 80% of community nurses actually have access to information from GPs.

A little over half (56.5%) had access to digital hospital discharge letters, and only 10.9% had access to social care records, despite nurses in the community often overlapping with social care.

“Systems used can be incompatible, and while there are information-sharing protocols, these were often not possible to use due to a lack of interoperability. In addition, systems are not always tailored to community nurses with unsuitable and ineffective systems from other parts of the heath service utilised inappropriately,” the report said.

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Another significant issue is connectivity, which leads to nurses struggling with mobile working. According to the report, 29% of community nurses still work on paper-based systems.

“Poor connectivity when mobile working hinders information technology from being used to best effect,” the report said. “Systems fail to update and/or synchronise, programmes used for recording information fail to load and systems crash. This leads to nurses having to use paper-based methods of recording information and duplicating this onto IT systems back at base.”

Another challenge is the cost of good IT systems. NHS organisations often work on yearly budgets, whereas the return on investment (ROI) of implementing digital systems is usually more long-term.

“The ‘up-front’ cost of IT in a tight financial climate serves to increase the risks of waste if technology is not fully used,” the report said. “Systems are prone to crashing and are slow, leading to frustration and compelling community nurses to work from paper.”

Some of the nurses surveyed also highlighted concerns that the use of IT took away from time spent with the patient, and that they often felt like the use of technology has “detracted from the role of being a nurse”.

High standards expected

Crystal Oldman, CEO of the Queen’s Nursing Institute, said the report shows a “complex picture”, and that due to the use of technology in their personal lives, they also expect high standards when using it at work.

“Community nurses demonstrate a general confidence in and acceptance of new IT systems that support efficient working and patient care,” she said.

“However, they also highlight in stark detail the challenges frontline practitioners experience with systems that are complex and which require high quality support from IT departments. In some areas, practitioners are frustrated by barriers to new technology, such as incompatible software systems and poor connectivity,” she said.

“When managed well, good IT systems should enable nurses to spend more time giving direct patient-facing care. However, when problems do arise, community nurses are concerned they spend more time managing the demands of IT systems rather than the pressing needs of their patients, families, carers and communities.”

The report also called on NHS organisations to involve clinicians from the beginning of the process when implementing new technologies, to ensure the systems work for those actually using them.

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