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Making better use of data feedback

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People in today's healthcare system benefit from nurses who are supported by technology. The majority of patient care is provided by nurses, who comprise the largest percentage of the healthcare workforce. Health information technology allows nurses to better monitor patient status, communicate with people, collaborate with team members, evaluate available care options, and determine best practices. The recent emergence of the availability of the summary care record (SCR), electronic health records (EHRs) and health information exchanges significantly expands the information available to nurses, which is changing the way decisions are made and providing nurses with new leadership roles.

It is well accepted that nurses are experts at providing patient care. They develop expertise through practice over time by providing care for many, varied patients. Nurses learn through experience, beginning during practical rotations, first in the lab setting, then in numerous care settings. Learning continues to be hands-on in the first years of the job during which the nurse transitions from novice to expert. As experience is gained, thought processes develop to mirror the complex nature of patient care. Nurses develop responses for tasks through repetition. Expert nurses have internalised these processes and no longer need to concentrate on the basic skills.

The complexity of healthcare does not always allow a nurse to properly assess outcomes directly. A pressure ulcer caused by poor skincare may not manifest for several days. The nurse may never know that their interventions were substandard, because feedback is delayed or non-existent. This leads nurses to believe they are providing good quality care when, sometimes, they are not.

To improve quality, outcomes must be clearly connected to interventions. Health information exchanges allow outcomes to be tracked across multiple providers, organisations, and care settings. Connecting patient outcomes to variations in care observed in EHRs creates an opportunity for quality improvement. Better care can be defined through data analysis, based on the outcomes of more people than a single nurse can care for. Information can then be shared with nurses in the form of care guides, algorithms and other decision support. Yet adopting these tools can be hard to accept for nurses who have come to rely on their expert intuitions.

Adoption of healthcare information technology can lead to reduced uncertainty and improved quality of care. Nursing care can be improved by moving from a world of individualised expertise based on personal experience to best practices refined by outcomes-based information. Value-based nursing care, informed by data, interpreted and applied by nurses, produces the best care for our patients.

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