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Title of research article:
Exploring nurses’ reactions to a novel technology to support acute health care delivery

Author names and titles:
B. Kent, PhD, BSc, RN, Professor of Leadership in Nursing, Plymouth University, Plymouth, UK
B. Redley,  PhD, BN, RN, Associate Professor, Epworth Healthcare and Deakin University, Richmond, Vic. Australia
N. Wickramasinghe,  PhD, MBA, BSc, Professor, Epworth Chair in Health Information Management, Epworth HealthCare and Deakin University, Vic. Australia
L. Nguyen,  PhD, BCompSci, Senior Lecturer, Deakin Business School, Department of Information Systems and Business Analytics, Deakin University, Vic., Australia
N. Taylor,  BN, RN, DATACOM Healthcare Solutions, Cremorne, VIC., Australia
H. Moghimi,  PhD, MSc, BEng, Research Assistant, Epworth Research Institute, RMIT University, Richmond, Vic, Australia
M. Botti,  PhD, BA, RN, Professor - Chair in Nursing, Epworth/Deakin Centre for Clinical Nursing Research Epworth Health Care, Richmond, Vic., Australia

All authors are credentialed and  credible sources for this peer-reviewed, scholarly article.

Article published within the last five years (2015).

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Summary of problem:
Founder of SmartWard, Matt Darling, struggled with the nursing care he received when he was dealing with the hospitalization and eventual death of his 15-month old daughter from a brain tumor. Darling’s analysis of the problem was the nurses did not lack skill or caring; rather, the nurses were saddled with an antiquated and clunky system needing a major overhaul. Darling is a successful IT systems analyst and designer, and self-taught computer programmer. He set out to create a computerized system  to support medical staff in hospital wards. Darling feels the system improves the delivery of care as the design of his electronic health records reduces errors in treatment while allowing nurses to spend more time with patients (Cadzow, 2013).

Link to nursing informatics:
Nursing informatics is the integration of nursing science, computer science, and information science allowing nurses to manage and communicate data, information, and knowledge (McGonigle & Mastrian, 2018).  Darling's creation of an electronic health record to streamline and improve patient care integrates the science of nursing care with computer science.

Links:
http://smartward.com.au/

http://www.smh.com.au/national/heart-and-mind-20130602-2nkn0

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SmartWard offers many positive innovations:

·         Replace paper-based nursing documents

·         Reduce administrative burdens on nurses

·         Remove duplication or double-handling of patient data

·         Support care planning and other activities to reduce the risk of missed care to improve patient safety
·         Key stakeholders (i.e. nurses) involved in initial concept and design and continue to be involved on an ongoing basis

(Kent et al., 2015)

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There are always negatives when it comes to integrating new technology in the health care field:
·         Nurses’ experienced with existing computerized health records commented that the systems made little clinical sense and were a waste of time

·         It is challenging to design a system flexible enough to meet the unique needs and sporadic and chaotic nature of the nurses’ daily workflow

·         Previously designed systems fall short of supporting the full scope of a nurse’s complex work—the systems do not think like a nurse

·         Nurse’s preconceived perceptions of new technology being a burden or a threat to their clinical skill is hard to overcome

·         New technology struggles with issues of responsiveness and reliability

·         Issues with security, maintenance, and confidentiality of patient records
(Kent et al., 2015)

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SmartWard is not the only computerized record system to try and revolutionize the way nurses run their day, nor will it be the last. A huge plus for SmartWard is its acknowledgement of the role nurses themselves must play in the development of the program for it to be accepted. As Kent et al. (2015) state: “Accordingly, adoption of technological solutions capable of supporting nursing practice, that could potentially improve care delivery and patient safety and outcomes, requires early contribution and buy-in from nurse end-users” (p. 2342). Bringing nurses into the development from the beginning is a good way to ensure both nurse buy-in of the new technology as well as creating a useful product for nurses.

Researchers Kent et al. (2015) showed the SmartWard prototype to a convenience sampling of nurses and asked for their input on what made a good computerized system. Nurses stated the most important aspect of any program was that it did not remove professional autonomy, but rather supported clinical practice via reminders and managed plans of care. Previous studies have shown there is greater user satisfaction when users are allowed input into design; accordingly, the nurses interviewed by Kent et al. felt similar satisfaction for their input on SmartWard and felt the prototype was “both reactive and interactive within the chaotic nature of their clinical environments” (p. 2347).

Given the research surrounding SmartWard, and its novel approach of allowing nurses to be involved in prototype design, this innovative technology holds great potential to use informatics to help nurses be successful in their daily tasks.

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Cadzow, J. (2013, June 8). Heart and mind. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/national/heart-and-mind-20130602-2nkn0

Kent, B., Redley, B., Wickramasinghe, N., Nguyen, L., Taylor, N., Moghimi, H., & Botti, M. (2015). Exploring nurses’ reactions to a novel technology to support acute health care delivery. Journal of Clinical Nursing, 24(15-16), 2340-2351.

McGonigle, D., & Mastrian, K.(2018). Nursing science and the foundation of knowledge. In D. McGonigle & K. Mastrian (Eds.), Nursing Informatics and the Foundation of Knowledge (4th ed., pp. 397-432). Burlington, MA: Jones & Bartlett Learning.

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SmartWard founder, Matt Darling
(Cadzow, 2013)