Developing IT Competencies in Psychiatric Nursing
Brandon L. Brown
Professor M. Young
Nursing 320: Introduction to Baccalaureate Nursing
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Technology has become ubiquitous in healthcare and, for the indefinite future, will continue to assert itself in the lives and practices of healthcare personnel as well as the patients they treat. In all types of healthcare facility, electronic health records (EHRs); computerized medication administration records (MARs), inpatient hospital pharmacy medication dispensation systems and many other forms of technology have streamlined the patient care process as well as offered unique ethical challenges to today’s healthcare practitioners. In ways that have not been true before, to be competent in practice is to be comfortable and competent using information technology (IT). Yet many nurses in the United States, according to a study by Wilbright et al.,(as cited in Koivunen, Valimaki, Koskinen, Staggers, & Katajisto, 2008) give low ratings to their computer literacy skills, stating that many “may not have the minimum computer competencies to perform their work effectively” (Koivunen et al., 2008, p. 1142). To deliver safe, quality care to patients in a technologically savvy world where ever more patients are using their computers to gain information about their care, it is incumbent on practicing nurses to be just as or more knowledgeable.
One of the specialty areas of nursing that has fallen behind in the realm of IT is psychiatry (Koivunen et al., 2008). There are many reasons for this. One is that there are a limited number of computer applications designed specifically to support psychiatric care (Koivunen et al., 2008) and even those that do may not lend themselves well to much of the subjective content involved in this specialty according to Carol Stevens, a registered nurse at the Toledo Hospital in Toledo, Ohio’s psychiatry unit (personal communication, December 8, 2013). Another reason may be that psychiatric nurses are “less capable of making effective use of applications” (Koivunen et al., 2008, p. 1142), afraid of negative consequences to patient care that may come from replacing face-to-face contact with patients with technology (Koivunen et al., 2008); but in a study done by Koivunen et al. comprising 466 healthcare workers in two hospitals in Finland, it was found that the main reason inhibiting computer use was lack of interest in computers (2008). It was also found that younger, more educated, and those in administrative positions were more likely to embrace using IT than their older, less experienced, and less interested counterparts (Koivunen et al., 2008). Yet older nurses remain a large part of the healthcare workforce, often doing the same jobs with the same consequences to patient care as their younger colleagues. These findings:
Raised a serious concern as to the extent to which healthcare staff in the field of psychiatric care are motivated, able or interested to support patients’ empowerment or active participation in their own care by using modern IT applications if the staff themselves are not interested in using the information and communication technology and helping the patients to use it. (Koivunen et al., 2008, p. 1147).
According to an article by Marilyn S. Fetter, there is an initiative at the national level to steadily improving outcome measures and reliance on IT and electronic records had been “cited as instrumental for improving the care of clients with mental health and substance abuse problems;” yet there are “only 27% of mental health studies and 10.5% of alcohol abuse treatment” that “adhere to clinical practice guidelines” (Fetter, 2009, p. 8). It is clear that something should be done to correct this trend.
Leadership has been cited as one of the ways that IT competence may be furthered (Fetter, 2009). If all of the psychiatric nursing leadership in hospitals, community agencies, nursing schools, and private practices got together, Fetter asserts, and agreed on a deadline for “meeting IT competencies and implementing IT integration,” as well as educational and other organizations “disseminating strategies, best practices, and evaluation methods in journals, newsletters, websites, and on Listservs,” the goal of competency would be greatly furthered (Fetter, 2009, p. 5). Moreover, the use of training programs that accommodate people of all ages and learning styles as well as the proper assessment of training needs, longer training time, more structure, lower student-to-instructor ratios, and the opportunity to practice prior to use in the clinical setting among other factors would go a long way towards inclusion of all practitioners in adapting technology (Fetter, 2009).
These and other strategies pay dividends in caring for psychiatric patients. “Internet multimedia programs for family caregivers of persons with dementia have demonstrated several benefits, including significantly reduced depression, anxiety, stress, and caregiver strain, higher self-efficacy, and positive impressions of caregiving” (Fetter, 2009). Web-based programs have been developed for teenage suicide survivors for reducing stigma, coping with bereavement, and providing resources (Fetter, 2009); also, an Internet-based self-help site for depression therapy “has reduced stigma and improved access for rural and school-aged clients” (Fetter, 2009, p. 7).
It is clear that the use of technology helps psychiatric clients. It is also clear that IT in healthcare is now the new normal and that paper is going to be for healthcare what the telegraph used to be for mass communication. It is incumbent for all nurses, therefore, to embrace technology for the betterment of quality and safe care.
Fetter, M. (2009). Improving information technology competencies: Implications for psychiatric mental health nursing. Issues in Mental Health Nursing 30(3), 3-13. DOI: 10.1080/01612840802555208.
Koivunen, M., Valimaki, M., Kroskinen, A., Staggers, N., & Katajisto, J. (2008). The impact of individual factors on healthcare staff’s computer use in psychiatric hospitals. Journal of Clinical Nursing 18, 1141-1150.