Table 3

Impact of ICT on NP role - representative quotes

Category

Quotation


Enhanced decision making

"when you think of something like [PowerChart] that's also helpful because you can electronically click back to someone's previous attendances which is usually very useful if they've represented with the same case or, gives you an idea if they're a regular attender here. You can look up their past blood results and do a comparison with how their bloods are today so, it's very useful. It definitely allows you to get a better picture as long as they've presented within [the Area Health Service] then you should have a lot more data on them than you would otherwise - otherwise you've got to ask a clerk to go and get their old notes and we might not have them and if they're offsite it could take 24 hours, so definitely expediates [sic] care, makes it faster and I think, probably gives you more information on which to base your decision making" [Site A, NP 3]

"it's great when you have a patient coming back, that's been here a week ago or whatever, when I can access and all the notes are on the system. It's brilliant because it's so hard when they're not, because you have no idea. The patient tells you something and they're not quite sure" [Site A, NP 2]

"viewing x-rays on the system, on the PACS system has a positive impact. Especially because I can talk to a registrar at [another site] or I can talk to a registrar here and he's looking at the same x-ray. That's really useful. So that impacts on my work. In a very positive sense that does" [Site A, NP 1]

"I can see all previous x-rays and all of the pathology comes back onto the system so again I can see layers of pathology, or dates of different pathology: I can see your last ten blood tests and do comparisons" [Site A, NP 1]

" I had a patient who came in with ischemic toe and his creatinine was a thousand...you see something as ischemic toe and then, looking at his previous blood results his creatinine was the same" [Site B NP]

"there are certainly advantages. I can do patient tracking so I can see what patients I've got. You can't lose notes in [PowerChart] as we're forever losing patient notes here like the paper notes. They're always being lifted by somebody and taken somewhere" [Site A, NP 1]

"I think now the systems in place you're not forever looking around for x-rays. You don't lose them" [Site B NP]


Improvements

"the only thing I find limiting is...a lot of the time you're struggling to get a computer and that's the frustration" [Site B, NP]

"physical access to [a computer] is sometimes really difficult" [Site A NP 4]

"Certainly more computers or PDAs or iPads or something like that. We've got COWs [Computers On Wheels]. They're okay but they're so big...imagine carrying one of those things everywhere. It's doable but anyway" [Site A, NP 1]

"what it has the power to do is improve the care given to patients so if everywhere in [the state] was on the same system and if everybody including GPs, clinics, private or public, if everyone had access to the PACS system then we would no longer have to print disks off all the time for GPs so I think for patients it has the ability to make things completely seamless and so if they'd been to a GP, I might then be able to click on [PowerChart] and actually access their last GP notes which would be incredibly useful to me because the number of people that come in here that say "I normally go see my GP but now I'm here", then I'm like, you know I wonder what they've been saying to their GP, is it different, or does this leg look any different? How on earth would I know?... so for me it would allow me to probably make more accurate decisions, otherwise I'm just going by what the patient's told me and quite often it's just very subjective information isn't it?... it could vastly improve the care of patients" [Site A, NP 3]

"it just needs to be expanded, it really needs to be expanded...we need to get things like medication charts, that's one thing. We really need to get medication charts on the system because that would wipe out so many errors - medication errors - if you have medication charts online. I worked with it before and it's brilliant because you can't have two medication charts and...it's all there. If it's signed for it's given, if it's not signed for it's not given and things like that it just, it's brilliant" [Site A, NP 2]


Li et al. BMC Medical Informatics and Decision Making 2012 12:27   doi:10.1186/1472-6947-12-27

Open Data