Legal, Ethical, and Policy Issues, Oh My!
Julia Colasurdo
SUNY College of Technology at Alfred State Abstract
Legal, ethical, and policy issues are an important aspect of nursing and medical informatics. Nurses should be aware of the dilemmas facing the use of informatics in the health care facilities. It is important to note the legal issues facing nursing because of the charges of negligence that can be incurred on the nurse if not aware. Ethical dilemmas of privacy including security breaches can be detrimental to the facility, and the patients. Nurses should also be aware of the policies regarding privacy, and confidentiality. These actions can help prevent issues and aid in improving the health care system, especially in
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Health care depends on information.” As nurses we have to be able to interpret the data and evaluate it’s accuracy. We also use it along with our assessments to care for our patients and identify when something isn’t right. This objective will help me to understand the legal, ethical, and policy issues related to the use of informatics in the work place. And it will also allow me to be not only aware of these issues, but will help me to understand and utilize the data in the intended way to help patients.
Legal Issues Legal issues related to medical informatics was destined to be a problem. Before health records were only paper based and there was constantly incomplete or illegible information that was difficult to dicipher. Now that electronic health records are commonly used, health care providers have access to unlimited amounts of data that’s perfectly legible. The amount of data now avaialable to the providers could almost be overwhelming. “This virtual “mountain” of data can lead to information overload, a new liability that can lead providers to overlook key findings despite reliable access to documentation. For instance, clinicians who miss a critical detail that affects treatment decisions while reviewing the EHR could in fact be liable for negligence because “the fact in question was likely just a few clicks away.”’ (Sittig & Singh, 2011). The use of electronic health records,
Informatics is a specialty in the nursing field that is combined with certain science. As stated by ANA (2008) “nursing informatics (NI) is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice” (p. 65). ANA further focus on the functional areas rather than the role that guides the scope of practice within NI. These functional areas include: “administration, leadership, and management; analysis; compliance and integrity management; consultation; coordination, facilitation, and integration; development; educational and professional development; research and evaluation; policy development and advocacy; and telehealth” (CCN, 2015, para. 1). With these functional areas in mind, a nursing informatics specialist can perform proficiently, depending on the specific task. Hence, the purpose of this paper is to summarize the result of an interview with a NI specialist and analyze the differences and similarities between the interviewee’s functional areas with that of scholarly ones.
Through education and clinical experience, I have gained the knowledge, skills, and proficiency that have prepared me an expert acute care nurse. This has developed the root of my personal philosophy of informatics. This philosophy holds the exceptionality of every individual and the certainty that everyone has the ability to improve his or her knowledge if directed in the right direction. Based on this, my ambition as an informatics nurse is to use
Within healthcare, practitioners often have to make difficult decisions regarding the care of their patients. This could be to do with giving or withdrawing treatment, or as simple as sharing risk information (Glover, 1997). Ultimately, the practitioner must be able to rationalise any decision they have made (Morrison, 2009). With this in mind, the following assignment will draw upon an ethical dilemma and explore how theoretical perspectives can be utilised within the decision making process. Therefore it will also be pertinent to draw upon the law, and how this influences actions within health care. To facilitate this discussion, I will identify a scenario from practice that
In order to practice as a nurse informatics or NI specialist, one must know and understand the standard to which he or she is held. The purpose and function of scopes and standards of practice for nursing informatics is to provide an overview of the specialty, assist future specialists understand their scope of practice, and practice at a competent level to guide and support nursing care. The scopes and standards of practice further provides an insight into the foundation of clinical decision making processes and cognitive concepts as the nurse moves data to wisdom in the clinical setting. As a NI specialist, the informatics nurse follows the concepts, scopes and standards of practice to guide and define their profession. This paper will further discuss the principles that guides nurse informatics specialist, the scope and standards of practice, professional performance, functional areas for nurse informatics, competencies, evolution, progress, and the future the specialty.
Ethics is part of the decision making process that a nurse uses and is a foundation of nursing. Nursing needs ethical standards to rely on in order to provide quality care for patients and to keep them from harm while respecting their wishes (da Silva Santos, Cartaxo, & Buriti 2016). Ethics is defined as a guide, or a code, that given populations use to model behaviors (Finkelman & Kenner 2016). When referring to the nursing profession, ethics are the driving factor when considering what is right and wrong. The goal of ethics in nursing is to provide a means to support the decision making process of the patient. Nursing informatics will be specifically discussed as a resource for the purposes of this paper. Only peer-reviewed articles from professional journals were reviewed. The ethical dilemmas the author will present surround the use of informatics in technology and how they now arise in the medical profession, with nursing in particular. The nursing code of ethics addresses the issues of patient rights. The nursing code of ethics challenges the nurse to provide complete and accurate information in order to facilitate informed consent, while weighing the benefits, responsibilities, and options for treatment (ANA
Information overload is a significant liability that a majority of the clinicians, working in the healthcare facilities within the United States of America, face. Due to the fact that the adoption of the EHR leads to the storage of virtually large amounts of data concerning patients; it is difficult for the clinicians to review all the relevant health information of the patients in a limited timeframe. In this case, a legal suite may ensue in the event that a clinician omits some crucial information relevant for treatment while reviewing records for a patient. The clinician could be sued for negligence with the understanding that the information was at his/her disposal (Blumenthal & Tavenner, 2013).
The health law field presently exists at the precipice of enormous change. Care providers must manage the legal implications that come with networked electronic health records (EHRs) and payment based on patient outcomes. Problems also arise due to patients travelling solely for specialized treatment and growing pains attributable to newly merged and acquired healthcare organizations. These factors and more contribute to increasing litigation involving fraud, insurance disbursements
The role of an NI is categorized as a non-clinical advanced nurse. The use of core competencies is an integral part of delivering standardized, measurable, quality healthcare in this day and age. Informatics is a relatively new addition to the APN, and nursing education but an integral part of delivering quality healthcare to patients. In 2010, the Institute of Medicine (IOM) mandated that nurses be key players in transforming and developing the infrastructure that is needed for efficient health information technology (HIT), thus, improving the quality of health care. Presently, informatics is a requirement for all APN 's. In prior decades, informatics was in the embryonic stages of development, but in 1992, the ANA recognised it as a speciality thursting NI to the forefront of nursing education and integerating informatics into the the very core of nursing cirriculum.
This exercise has affected my knowledge because it has made me realize the little things we learn in nursing school, such as knocking on someone’s door and introducing ourselves are really big things that make big differences in patients’ lives. This exercise made me realize that this is their home for now and we should treat their home with respect. It has affected my skills because it made me more conscious when it comes to disclosing patients’ health information. Informatics is described by QSEN as the “use of information and technology to communicate, manage knowledge, mitigate error, and support decision making” (QSEN, 2014). The patient’s electronic health records allows health care professional easy access to patient information. This exercise has changed my attitude because although this is a great system we still have to protect patient information that means when we leave the computer unattended we should log out of the patient record so that their information is not shared with
Nursing informatics (NI) has become a vital part of healthcare delivery and has become a defining factor in the selection, execution, and assessment of technology that supports safe, exceptional quality and patient-centered care. Nursing has become so uniform. The data in patient records has become a valuable resource and has improved assessments and overall patient care. Before the launch of nursing informatics throughout the second half of the 20th century there were not any real standards for language. The use of data restricted the function and
With the rapid growth in the implementation and use of electronic medical records, there is an increase in how we define the role of nurses and other team member’s (Deese & Stien, 2004). Along with providing optimal care, nurses are also responsible for interpreting and accurately documenting large amounts of information. According to, (Ericksen, 2009) nursing informatics is defined as the integration of nursing, its information, and information management with information processing and communication technology to support the health of people worldwide. In this
Health information technology (HIT) has become a growing phenomenon in the past sev-eral years. Healthcare providers, organizations, policymakers, and patients all share a similar vi-sion of a healthcare system powered by information technology. These visions stem from the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which authorizes grants and incentives to promote the use of electronic health records (EHRs) by pro-viders. In the past couple of years, with the implementation of HIT and EHRs, the healthcare field has had an increasing amount of medical malpractice lawsuits. Unfortunately, with technol-ogy advancing more rapidly, causing medical professionals a difficult task in identifying and ad-dressing medico-legal issues before they occur. Therefore, healthcare teams are in need of con-sidering how to fix the underlying problems of HIT in order to ensure malpractice lawsuits do not continue to happen in practice.
In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR). Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) “ethical concerns shroud the
Sir, can you please step up to the glass, put your palm on the screen and follow the directions from the computer? This is where our future lies…in biometrics, computers, and science. Soon there will be no need to fill out tedious paperwork, to try to remember medications or past medical history. I know it exists in hospitals across America, I have seen it in action many times. Are we as nurses changing with the times? What is nursing informatics? Why is it important to me? How do I rate on the nursing informatics knowledge scale? What is my plan to increase my knowledge base? These questions should be at the forefront of every nurse’s thoughts. The information age has come crashing down on us from every possible angle in our lives, it
Nursing informatics is a branch of nursing or area of specialty that concentrates on finding ways to improve data management and communication in nursing with the sole objective of improving efficiency, reduction of health costs, and enhancement of the quality of patient care (Murphy, 2010). It is also described as a growing area of nursing specialty that combines computer science, information technology, and nursing science in the management and processing of nursing information, data, and knowledge with the sole objective of supporting nursing practice and research. Various nursing theorists have formulated various theoretical frameworks or models related to nursing informatics (Wager, Lee, & Glaser, 2013), and they are defined as a