Ethics and Safety in Nursing Informatics Essay

Definition of Ethics and Nursing Informatics

Nursing informatics (NI) is defined as “a special area which combines nursing science, information science and computer science for managing and communicating data, information and knowledge in nursing practice” (Rajalahti, Heinonen, & Saranto, 2014, p. 47). NI is meant to support professional performance and patient outcomes, but, at the same time, it provokes challenges in nurses’ competence development and ethical use of information. NI-related ethics are primarily associated with confidentiality concerns and patients’ consent for data disclosure. To avoid harm to patients, a nurse needs to understand ethical principles and strive to practice them daily.

Ways to Teach and Enforce Ethical Use of Information

As a supervisor, I enforce ethical information use by teaching nursing team members to employ ethical models of decision making. For example, to make an adequate decision in a difficult situation, it is possible to implement the five-step model for ethical decision-making also known as IDEAL. The model includes five major steps: identify, develop, explore, act, and look back (Knapp & VandeCreek, 2006).

I suggest nurses analyze hypothetical cases of information misuse by following the given models and predict potential outcomes of a made decision or professional action on patient well-being. Additionally, I strive to recognize the nurses’ success in employing ethical standards because it helps them to develop a more in-depth understanding of the criteria for ethical professional conduct.

In the case when a patient did not give his/her consent for sharing information and assessment data even among team members due to his personal beliefs and healthcare perceptions, but since the health issue was challenging and the consultation with other nurses was required, the ethical dilemma takes place. According to the IDEAL model, a nurse needs to identify the problem and evaluate the potential outcomes of a decision.

It is suggested that, first of all, nurses need to inform patients about the type of the accumulated data that may be disclosed and with whom it can be shared prior the beginning of the assessment or consultation while a patient always should be provided with the opportunity to refuse the assessment to avoid the situations which imply the nurse needs to coordinate the extent of patients’ involvement in the process of information sharing, obtain their informed consent, and cooperate with them professionally and ethically.

The Ethical Implications Related to Nursing Informatics

In my hospital setting, the ethical principles of non-malfeasance and confidentiality are being practiced continuously. For example, when collecting and using patient assessment data mediated through electronic carriers, the personnel follows strict regulations in system access and information sharing. Patient consent is required to disclose personal health data.

Moreover, the role-based control of system access is practiced to track information movement. Since digital format fosters information sharing and provokes the risks of personal information disclosure, such access control activities are of great importance. The disclosure of personal patient data may have a significant impact on their social and psychological identity. Therefore, compliance with the principle of confidentiality and non-maleficence is an integral component of ethical professional behavior as it eliminates the possibility of damaging patients’ well-being.

Strategies to Teach the Information

NI competence and ethical use of technology are interrelated. Therefore, a nursing education strategy should comprise three steps aimed at the development of basic computer competence, advanced NI competence, and awareness of ethical standards and principles. As mentioned by Rajalahti et al. (2014), advanced NI expertise includes such aspects as “information literacy and information management competence” (p. 49).

The second aspect is especially important for the successful enforcement of ethical principles in technology use as it refers to nurses’ skills in the utilization of different types of data, including theories and terminology, as well as their ability to comprehend legal and ethical implications of information security.

Ways to Enforce the Principles of the Ethical Use of Information

An effective education strategy in nursing employs different ethical standards of professional conduct, such as the American Nursing Association (ANA) Standards of Professional Nursing Practice. And the best way to enforce these standards is conveying information to nurses and attempting to develop an understanding of what type of behavior is expected from them.

ANA standards provide the necessary information about nuances of nursing practice, the establishment of professional relationships, usage of patients’ confidential information, and other critical elements of nursing competence (American Nursing Association [ANA], 2010). Therefore, it is important to encourage the research of ethical codes and other evidence-based literature in the nursing team to raise individual awareness of the topical issues and stimulate compliance with ethical organizational regulations.

Safeguarding Health Information and Systems

Modern healthcare informatics technologies allow health care providers to access patients’ information anywhere and anytime through multiple computer and mobile devices. Facilitated access and information sharing among medical staff members and patients are associated with such information security risks as “inherent vulnerabilities of popular mobile operating systems,” “sharing of mobile devices by multiple users,” “transmission of clinical images over public (unsecured) wireless networks,” and “failure to use recommended safety precautions to protect data” (Piliouras et al., 2015). While safeguarding practices are commonly regarded in connection with technical equipment and environment, it is important to remember that the user environment and the level of technology users’ competence and awareness regarding ethics and information security issues are essential to data sharing and data storage protection.

Ethical Computing Statement

No person can access, or attempt to access, NI Technology (hardware, software) restricted by user privileges, and user accounts assigned to other team members. An authorized person’s negligence in disclosing his/her account data does not allow others to access confidential patient information freely. It is also impossible to lend accounts to other users.

The extent of each staff member’s access to NI activities and patient information imposes responsibilities on him/her in the ethical use of an account. A nurse should strive to protect data confidentiality and integrity. All NI users should know and respect ethical and legal regulations, and comply with organizational policies. In information use practices, nurses should follow ethical standards of beneficence and non-maleficence as stated by ANA ethical code of conduct.

NI Skills and Impact on Speciality

Second Life Experiences

The course provides a favorable virtual learning environment which facilitates interactions with peers and professors and stimulates for the engagement in the knowledge building process. A learning 3D environment is an innovative strategy for fostering distance education. It allows students from any country to access education in best institutions and obtain memorable experiences from being part of a large international community.

Nursing Informatics Skills

The course allows nurses to develop necessary competencies in operating NI technologies. Course practices allowed me to understand that a nurse’s work efficiency depends on her/his level of technical, clinical, and theoretical proficiency. NI skills constitute a significant portion of nurses competence because hospital environment is changing from a traditional format to digital one, and it is important to keep up with the pace of these changes, be able to solve NI-related problems, analyze different situations, and think critically to ensure patient safety and confidentiality.

Impact on Speciality

The course allows developing an evidence-based approach to the targeted patient groups. The course provides detailed and precise guidance for medical staff members’ skills development. Along with clinical assessment skills, Impact covers such important aspects as ethics, patient consent, and ceiling of care. The course prepares a care provider to encounter challenges in decision making and overcome them in the most efficient possible way. Thus, Impact is of significant importance.

Nursing Informatics Course: Activities and Outcomes

NI course aimed to increase nurses’ self-efficacy and development of professionalism. The course activities were performed to increase the level of competence including theoretical knowledge, computer skills, awareness in legal and ethical aspects of professional practice. The course activities were based on the research of scholastic evidence, theoretical frameworks, and technological nuances that can be effectively applied to work and can contribute to the development of professionalism and self-efficacy increase.

The activities supported the development of NI skills and sufficient awareness regarding ethics of conduct which may be considered the major components of professional competence. It is possible to say that the skills and competencies acquired throughout the course can help to avoid multiple issues that may arise in a computerized environment and gain as many benefits in treatment, collaboration, and provision of patient-centered service from it as possible. Like it was mentioned above, a computerized hospital environment entails many challenges of organizational, legal, and ethical character which require attention and commitment to their resolving from each staff member.

But the knowledge regarding the issues of NI developed during the course helps to improve individual and organizational performance and adopt appropriate patterns of ethical conduct which primarily implies an ability to show respect to diversity and dignity of patients and other individuals with whom a nurse interrelates in the professional context. The knowledge accumulated during the course stimulates the evidence-base practice and further engagement in self-education and development of NI skills.

References

American Nursing Association. (2010). Standards of Professional Nursing Practice.

Index for Excerpts from the American Recovery and Reinvestment Act. (2009). Web.

Knapp, S., & VandeCreek, L. (2006). Practical ethics for psychologists: A positive approach. Washington, DC: American Psychological Association.

Piliouras, T. C., Suss, R. J., Yu, P. L., Kachalia, S. V., Bangera, R. S., Kalra, R. R., & Maniyar, M. P. (2015). The rise of mobile technology in healthcare: The challenge of securing teleradiology. 2015 12th International Conference & Expo on Emerging Technologies for a Smarter World (CEWIT). Web.

Rajalahti, E., Heinonen, J., & Saranto, K. (2014). Developing nurse educators’ computer skills towards proficiency in nursing informatics. Informatics For Health & Social Care, 39(1), 47-66. Web.