Nurses are the backbone of Singapore’s healthcare system and they play an important role in transforming the healthcare industry. President Halimah Yacob highlighted the significance of nurses during the International Council of Nurses’ biennial congress that was held earlier in June. It is essential that we introduce measures to support the unsung heroes of our healthcare system through the adoption of technology. This will help grow and develop the nursing workforce to address challenges in the healthcare system.
With the rising demand for healthcare services and an ageing population in Singapore, it is projected that there will be a 13% shortfall of nursing manpower by 2020. One of the contributing factors is the lack of career development opportunities and training support. Nurses need to bridge the knowledge gap between translating theoretical knowledge learnt in classrooms into practical clinical skills used in the hospital setting, which could empower them with the knowledge to deliver more efficient and safer care to patients.
Whilst Singapore is introducing more development courses for nurses, given Singapore’s Smart Nation push and increasing emphasis on leveraging technology to transform the way we work; it is timely to explore how technology can help support nurses to increase their efficiency through bridging the knowledge divide.
1. Raising the quality of nursing skills with ongoing education
Improving the knowledge divide amongst nurses in Singapore begins with education. Education is the key determining factor in enhancing the performance of the nursing workforce to provide better care to the patients. Massive amounts of information are uncovered each day and learning is a continual cycle that never ends. Nurses need to be updated with the latest medical knowledge in order to provide the best quality of care to patients.
Investment pertaining to education and training on clinical procedures, policies and best practices is very important in minimising preventable medical errors and reducing variability in care. Nurses need to undergo continual training and in-service education as part of their career development pathway to keep abreast of medical knowledge and new developments in healthcare.
Enabling nurses to manage their professional skills training, education and competency validation via an intuitive and customisable online training solution empowers them to improve the standard of care they provide. For example, our interactive evidence-based online training solution, Clinical Skills, combines competency management features with over 1,500 evidence-based skills and procedures, to create an engaging learning experience that helps nursing graduates learn entirely new skills.
2. Providing training to onboard new nurses
Nursing turnover rates have always been a cause for concern and with each nurse who leaves, healthcare providers face the issue of the “leaky bucket” syndrome. The “leaky bucket” syndrome refers to the process where little bits of information are leaked when information is passed from one individual to another. Whilst there are sufficient programs put in place to train new nurses, the “leaky bucket” syndrome leads to an inconsistent provision of information whenever a new nurse is being trained.
To resolve the “leaky bucket” syndrome, it would be ideal to leverage technology to provide a common set of educational and training resources. Clinical eLearning solutions can support the training of new nurses by providing authoritative, online continuing education courses. It contains common sets of information and the most up-to-date knowledge that is easily accessible by everyone. This helps to unify the information available to nurses and maintain a level of consistency with the training.
3. Supporting nurses to grow their careers
Beyond nurse clinicians, nurses who find their calling in other fields can expand their roles and explore the different nursing career tracks – education, research and informatics. Nurse educators pass on knowledge and nurture aspiring nurses. Nurse researchers initiate and champion clinical studies to contribute to practice changes. Nursing informatics integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. The common denominator amongst these tracks is knowledge. Nurses need a good grasp of medical knowledge regardless of the role that they take on to develop their potential for professional growth.
Information structures, information processes, and information technology provide nurses with quick access to the necessary evidence-based knowledge needed to broaden their skillsets. By doing so, they are supported to progress their careers and / or to take on a different role.
For example, ClinicalKey for Nursing connects nurses to trusted answers and provides in-depth access to evidence-based information that is continually updated. With this trusted resource that is backed by the latest evidence and research findings, nurses can proactively retrieve the information they need to expand their knowledge base and develop expertise in making clinical judgements to advance their career.
Providers of healthcare need to ensure that enriched training and support of nurses’ career development is linked closely to recruitment and retention initiatives to drive value from their investment in staff. This is especially important as nurses are invaluable assets to the organisation. A study conducted in Philippines has shown that a lack of professional development opportunities is a factor in high turnover intentions amongst nurses . To decrease the intention, organisations need to strengthen nurses’ commitment to the organisation. This can be achieved when nurses feel valued through the initiatives that the organisation provides, such as training and education.
4. Enhancing the productivity of nurses
Nurses have a diverse portfolio, from tending to patients’ medical needs to carrying out administrative duties, which can be time consuming. This is where technology can come into the picture and help automate these processes to improve the productivity of nurses.
According to the 2014 National Physician Survey conducted in Canada, 75% of physicians are using an electronic medical record system and of which 65% indicated that patient care improved . The majority of hospitals in Singapore have an electronic health record (EHR) system for nurses to access patients’ medical information at the point of care.
As EHRs are now a common addition in many healthcare settings, organisations must take advantage of the EHR technology to support nursing knowledge and decision-making at the point of care. It is also essential that nurses understand the fundamentals of digital health technology and how to use EHR.
Increasing adoption of clinical decision support (CDS) tools that are evidence-based, such as care planning, is an effective mechanism to turn an everyday activity with little perceived value into a dynamic process that empowers the nurse with actionable knowledge. With the availability of information easily accessed at the point-of-care, nurses will be empowered to be more proficient in their daily activities, thus improving productivity.
5. Improving the patient experience
Nurses are at the frontline of caring for the patients and they form a large part of the patient’s experience during their stay at the hospital. According to the Hospital Consumer Assessment of Healthcare Provider and Systems (HCAHPS) survey conducted in the United States, it has been found that strong nurse communication was one of the key factors driving good care experience scores from patients.
Communication is a two-way process and patients appreciate nurses who make the effort to listen. This alleviates their fears and concerns and allows them to be more involved in their care journey, thus promoting a better patient experience. From the survey, it was also found that patients value nurses who speak to them about healthcare concepts as it gives a better overview of the treatment process and journey.
Effective communication of these healthcare concepts begins with a well-founded knowledge base. With technology, such as CDS tools, nurses can retrieve the latest evidence-based guidelines at the point of care. It empowers them with the technical knowledge to confidently communicate care plans to patients in a better and safer manner. A better understanding of treatment plans allows patients to feel more assured of the care that they are receiving, which serves to improve the patient experience.
Nurses are the core of the healthcare system and more needs to be done to appreciate their efforts and develop their capabilities. These issues in nursing shortage and retention are problems that need long-term solutions that require time. What can make a difference in our immediate future, however, would be the adoption of evidence-based technology to help increase the efficiency and quality of care. It also provides continuous training to expand the skills of nurses and support them at every stage of their career development. With that, nursing as a profession can also become more respected within the industry.
The views expressed in this column are the author's own and do not necessarily reflect this publication's view, and this article is not edited by Health Care Asia Magazine. The author was not remunerated for this article.
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Tim Morris is the Commercial Portfolio and Partnership Director at Elsevier, working as the experienced healthcare professional in Clinical Decision Support & Hospital Workflow Solutions across the EMEA/LA region.
He has nearly 30 years of healthcare experience, from delivering care as a nurse in a London A&E Department, research and management within the NHS, to direct sales and product development with a range of public and private health companies. He is an experienced board member with international exposure and has displayed his well-established experience of decision support and knowledge management systems during his 4 years at Elsevier working on Clinical Decision Support Solutions. He has been working at Elsevier since 2015.