Nursing Information System (NIS) refers to the application of computer science and information science to manage operations involved in nursing. The advantages and disadvantages of NIS have been briefly outlined here.
A study has revealed that nurses spend only about 15% of their time in direct patient care, and more than 50% of their time in maintaining and managing patient data.
Information technology has revolutionized data management and documentation in almost all the industrial sectors, including health care. The use of computer-based information management systems in the field of medicine and health care has come a long way since its inception in the 1950s.
A significant part of the health care industry is the discipline of nursing. Nurses form the largest group of professionals that directly influence the quality of services received by a patient as well as his/her caregivers. Their responsibilities include assessing the needs of a patient, planning and timely administration of health care services, as well as evaluating and managing emergencies.
Nursing information system (NIS) is a type of clinical system that helps to manage nursing data as well as activities. Some of the advantages and disadvantages of nursing information systems have been explained below.
Nursing information systems are beneficial in several nursing roles, including managerial roles, coordination of activities, performing physician-delegated tasks, and tendering to any other requirements of the patient. Some of the reasons why information systems are helpful to the nursing discipline are as follows.
Better Staff Management
NIS provides an efficient way to handle administrative activities like workload management, maintaining staff records, scheduling shifts, etc. In addition, the tasks accomplished by each nurse can be recorded, and such shift reports can be reviewed in a patient-specific manner. It also aids nurse administrators in assessing staffing requirements, as well as financial management through budgeting and monitoring of expenses.
Proper clinical documentation is the pillar of every health care system, and NIS provides an easy way to record all the necessary data, in a systematic and uniform way. The data may include drugs to be administered and their dosage and time; schedule of medical tests and their results; and relevant vital parameters of the patient like daily records of body temperature, blood pressure, etc. NIS reduces the need for redundant paperwork, and also enables maintaining patient history that can be easily accessed when required.
In addition to storing data, certain features of NIS enable information management and decision-making through active and passive systems. Passive systems can organize and format the data according to preset parameters, as well as provide parameter-specific information, as and when required. Active systems are a step advanced and suggest diagnoses on the basis of predefined criteria applied to the patient information.
Patient data generated in all the units is always essential for the decision-making in any unit of a medical facility. This can be achieved through the integration of NIS with other clinical systems, which enables fast and easy access of the documented information to all the appropriate units.
In spite of the advantages mentioned above, nursing information systems are not easily accepted. Some of the drawbacks that have contributed to their limited use have been outlined below.
Need for Training
One of the reasons why NIS is not widely implemented is that the nurses need to be trained for the use of various features provided by the system. Certain studies have reported that sometimes the nursing personnel find it difficult to understand the design of the system. In such cases, it increases their workload rather than helping them.
Long Charting Time
The initial time required for creating the record for a new patient may require more time than the regular paper-based charts, due to a variety of fields that need to be filled.
Difficulty in Customization
Clinical systems require a higher degree of customization, not just with respect to the particular health care facility, but also at the level of the patient. Each patient may have a different set of parameters to be considered as vital. The protocols to be followed for a particular process may also vary from patient to patient, depending on his/her physiology, ability to bear pain, etc., which cannot be reflected through NIS.
Lack of Standardized Vocabulary
NIS serves as an excellent tool to document medical information, but at the same time it lacks a standardized language for the same. Although there is some level of standardization in the nursing terminology based on which certain terms in NIS can be classified, there is always scope for ambiguity. For example, if ‘abdominal pain’ is one of the entries in the system, a detailed expression indicating the intensity and type of pain needs to be known, in order to ensure a correct inference. Moreover, the terminology available in the system may not match that of every user, which causes confusion, making it difficult to use.
Information systems have greatly influenced management of information in several disciplines of health care, including diagnostics, treatments, nursing, as well as palliative care. With their speed and accuracy, NIS confers several advantages as far as nursing is concerned. But, there still remain certain drawbacks that need to be tackled in order to improve their efficiency and usability.