Nursing Essay: Informatics Systems and Person-Centered Care Evaluation

This essay delves into the pivotal role of nursing informatics and online social media in enhancing patient-centered care. It begins by defining patient-centered care and its core principles, emphasizing the importance of information technology in achieving it. The essay then examines the Enterprise Patient Administration System (EPAS) used in South Australia, detailing its advantages such as information sharing and dynamic display, while also addressing challenges related to patient privacy, health literacy, and the need for improved nurse training. Furthermore, it explores the use of online social media platforms, specifically Facebook, in nursing practice, highlighting their benefits in reaching remote patients, creating awareness, and fostering communication. The essay assesses the effectiveness of social media in delivering person-centered care, acknowledging both the opportunities and challenges related to privacy, confidentiality, and ethical boundaries. The analysis includes relevant policies at the regulatory and service levels, providing a comprehensive evaluation of these systems' impact on nursing practice and patient outcomes. The essay provides insights into how these technologies can facilitate the therapeutic relationship between the caregiver and the user.

Running Head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
Patient centered care is an important aspect of nursing and high quality care. The use of
the nursing informatics and the online social media helps to facilitate the person centered care.
The key features of the both the systems are discussed in the essay. Further, the quality of both
the systems in nursing practice to deliver the person centered care is evaluated. The evaluation is
based on elements of dissemination of information, efficiency, ethical issues, potential related to
the management of patients, confidentiality and privacy. The opportunities of these system in
promoting innovation in nursing or establishing the therapeutic relationship with patients is
discussed. The analysis also includes the relevant policies at the regulatory level and the service
level.
Person centred care
Patients should get right care at right time. This is possible if they receive the right
information, by right providers. Information technology is useful to give right information to the
patients and it is the heart of the patient centred care. Person centered care is the type of care
given to the patients that adds value and meaning. Person centered care is the nursing principle
of treating each patient equally, individually, by establishing therapeutic relationship with them.
Therapeutic relationship between the caregiver and the user is based on mutual trust and
understanding (Entwistle & Watt 2013, p. 30).
Respecting the client’s cultural values, needs, and preferences is the first principle of the
patient centered care. It helps in decision-making as the client feels that his/her dignity,
autonomy and respect are maintained. The second principle of the person-centered care is the

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care coordination and integration. The feelings of vulnerability and powerlessness can be
eliminated by coordination of clinical care, frontline patient care, and the ancillary support. The
third principle is the promotion of health by providing the right information and education to the
patients. The fourth principle is the provision of emotional support and enhancing the physical
comfort to decrease anxiety and fear in patients. The fifth principle is family involvement for
shared decision-making and the last principle is to help the patient’s self-caring capability after
discharge. It also includes supporting the patients to have continuous, social, financial, physical,
and clinical support (Eaton Roberts & Turner 2015).
Health informatics
Health care information, with the use of technology can be acquired and stored. It is
called informatics. Nurses use informatics to provide information to the clinicians. The clinicians
can use this data and integrate the information to deliver patient centered care (Snyder et al.
2011).
Nurses use electrical health record system or EHR to manage complicated health data of
the patient. ePAS which stands for “electronic Patient Administration System” is the
foundational module of the EHR and it provides free and open source software. Informatics
allows to have the participatory care record that improves the patient centred care (Snyder et al.
2011). In this paper the main focus will be on EPAS
EPAS- Enterprise Patient Administration System
In South Australia, the EPAS patient record system is widely used. It is the new
electronic health record system that allows to have all the patients health record in one place. The
health care providers use the patient’s data recorded electronically. It is no more exist in hard

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copy format. This electronic record comprises of both clinical details (diagnosis, treatment plan,
list of medications, scans and others) and the administrative details (name, address, date of birth,
appointment lists etc). With this system, the clinical staff will have all the information at
fingertips. They can review these records anytime and decide about the required tests and
medications electronically at the bedside of the patient. It indicates the effective care, with more
face-to-face time with the patient (Sahealth.sa.gov.au 2017). The various advantages of EPAS is
discussed in the subsequent sections.
The advantage of EPAS is the sharing of the clinical information to the multiple
providers. It assists the nurses to collaborate with the multidisciplinary team members at a time
as more than one member can access the information in a given time. This process aids in quick
decision-making, as there is no delay in the data retrieval and transfer between patient and the
health providers. Thus, this tool acts as a bridge between the patients and the nurses and
eliminates the communication gap. However, without the use of appropriate technologies, it is
difficult to make use of the potential of EPAS (Hanna 2017, p. 495). This novel approach
provides dynamic display system. It prevents the hassle related to patient’s information being
buried in hundreds of pages. Instead, at the point of care, it meticulously displays the vast history
of the patient, along with the patterns of responses, and other essential aspects of their lives. The
medical records in the static history are lost and moving these records from here allows to
personalise the care. It is also advantageous to use when the patient’s speech is impaired (Sewell
& Thede 2013).
Several researchers studied the effectiveness of delivering the person centered care in the
nursing by the use of informatics. As per the assessment report by McGonigle, the patient safety
is increasing and improving by the use of nursing informatics, particularly the EHR and EPAS

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system. Nursing informatics helps in collecting evidence related to patient’s health issue and
design appropriate intervention. Patient can complain on allergies due to medication or any
complication in EPAS system. Thus, it is leading to evidence based practice. It can be concluded
that the nursing informatics is significantly influencing the clinical practice. It is advantageous as
it decreases the time invested by the nurses in the indirect care. These reports showed an
improvement in the nursing diagnosis and the identification of the treatment symptoms. Further,
an overall improvement was noticed in treating the psychosocial problems using EPAS. It
pertains to quick data capture and its integration in the point of care. EPAS also improved the
person-centered care in oncology nursing care (McGonigle 2014, p. 324).
The major challenges with EPAS involve compromising the security of the patient’s
health information. As per the evaluation of the nursing informatics particularly the EPAS
system by Demiris & Kneale (2015, p. 15), there are several drawbacks to the system. Patients
are worried to lose their privacy and confidentiality of information. Breach of privacy may
involve several ethico-legal consequences. Other factors that are undermining the potential of the
nursing informatics are lack of feasibility, social inequality and health literacy of patients. Nurses
are also facing challenges due to vast array of information from which they have to find the high
quality information for application at point of care. In some cases, the nurses were found to fail
to integrate the clinical data of the patients. It was due to the lack of computer skills and
sufficient knowledge on the information technology. Further, in EPAS system there is lack of
appropriate list of drugs used in South Australia, as it is American based software. It prevented
them to promote or access health websites. The nurses failed to consider the integrity of the
patient’s data, accessibility and accountability for errors. On the other hand, the use of

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technology has also improved the nursing productivity as it created, positive attitude and reduced
medication errors (Snyder et al. 2011, p. 211).
It is recommended by the AMIA to initiate the training and education programs for
nurses on use of informatics (AMIA 2013). The nurses should learn to use innovative and
analytic techniques for scientific inquiry and the way to interpret the information flow. Nurses
should comply with the “National informatics standards for nurses and midwives”. The
Australian Nursing and Midwifery Federation” (ANMF) developed these standards. These
standards emphasise on the information literacy, management and computer skills for all nurses
and midwifes (Eaton et al. 2015).
Online social media
Social media adds new dimensions to nursing practices by acting as a tool for networked
care. This online social media comes in various forms say websites, Facebook, Twitter, online
blogs. With the advent of smartphones, it is easy to connect with people from distant places just
in one click. This platform helps the nurses to give update to the clinicians, physicians, medical
students and other nurses about the patient’s health status. In this system, both the patients and
the providers use the digital social networks (Hao & Gao 2017, p. 2). The advantage of this
online social media platform in nursing practice is to reach out to the patients living in remote
areas. Writing the health promotional blogs can better help the patients to engage in health
behaviours. It is useful to motivate the patients through blogs to undertake the behavioural
change. Websites like WebMed and Mayoclinic discuss the pathophysiology of disease in a lucid
language avoiding too many jargons. Similarly, Twitter is other tool for nurses and is the easiest

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way to connect with people during crisis, health safety alert or drug recall information
(Bornkessel, Furberg & Lefebvre, 2014, p. 504).
In this section, the focus will be on the use of the Facebook pages, by nurses to promote
patient centered health.
Facebook page
Facebook pages such “HER 2 positive Breast cancer patient/family survivors group”, “I
have Cancer leukemia”, helps patients to share their health status and access relevant treatment
or care support. These groups on specific illness create awareness (Hao & Gao 2017).
The use of Facebook pages such as “I have Cancer leukemia” have several advantages.
Nurses can directly connect with patients to access their medical information and communicate
with the family members as well. This tool not only aids in socialising for the nurses but also
personalise the care (Moorhead et al. 2013). This Facebook page helps the nurses to have a
debate on particular health issues to gain broad perspective with engagement of large number of
people at a time. It is useful to promote the primary health care and exchange ideas on treatment
options for people from diverse communities keeping in mind their health perspectives. It is
useful to create alert on specific diet plan for particular cancer or inform about precautions to be
taken or alert on disease outbreak. Nurse can answer emergency questions of patients. The
delivery of the health care is enhanced by use of Facebook. As everyone, these days use
Smartphone and Facebook awareness can be created rapidly (Shepherd et al. 2015, p. 29).
The ability of the Facebook pages and the other social media platforms to deliver the
person centered care was assessed. Grajales (2014, p. 20) received feedback from patients who
shared their health information over the Facebook. The data collected from the unstructured

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interview showed that Facebook pages on cancer awareness pages improved the health outcomes
of the patients. It facilitated the active involvement of the patients due to facility to upload
videos, post images, leave private or public messages. Social network improves two-way
communication between nurses and the patients. Thus, nurses can better empathise with patients.
It has proved to be advantageous for the cardiac patients. Cashin (2014, p. 550) argued that there
is lack of strong supporting evidence that there are no ethical issues involved in use of social
media by nurses. The challenges related to privacy and confidentiality of information remains.
The ability of Facebook users to create fictitious profile can lead to skewing of data. Third party
applications is the other drawback as they interfere with the other facebook users, having high
chance to leak essential medical information (Casella, Mills & Usher, 2014, pp. 122).
Further, the nurses fail to understand the synergy between the evidence based practice
and social media. There are incidents of self-aggregated negative-behaviour promoted by online
social media (Cashin 2014, p. 550). For example, the cancer patients group in Facebook fail to
serve as a model for patient-to-patient support. Sometimes the only purpose is to raise funds and
create awareness. There is also a high risk for the nurse professionals to cross the professionals
boundaries. This may include engagement with the client in intimate relationships or for
monetary benefits and others include business transactions. Such private conversations cannot be
evaluated, unless the patients expose the content. The “Nursing and Midwifery Board of
Australia” (NMBA) has formulated the social media policy to which the nurses must adhere
strictly (Nursing & Federation 2015).

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Conclusion
In conclusion, the information is the basis of all the managerial activities in the industry
of nursing care. The ultimate product of the nursing care is the patient satisfaction. There are
multiple benefits of the use of nursing informatics and the online social media used for
delivering high quality care. It gives opportunity to the nurses to better collect the evidence.
Consequently, it promotes the person centered care. The major benefit of both the system
altogether include quick access of patient’s records, delivery of care on time, smooth sharing of
information to the stakeholders and fast decision-making. However, the disadvantages to the
both system includes privacy and confidently issues related to low data security. Overall, both
the system are effective in promoting the person centred care. In order to avoid challenges
pertaining to informatics and social media, the ANMF and NMBA policies should be used by the
nurse.

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