Information technology (IT) is the use of computers to gather, organize, process, and communicate information. Information technology is used in clinical nursing practice, nursing education, and nursing research. For example, IT is used to deliver distance learning programs, to provide staff development lessons, to create staffing schedules, and to develop financial and administrative reports.

In the hospital setting, technology has provided tools for accurate and safe client care, such as computerized intravenous infusion pumps, patient-controlled analgesia (PCA) machines, pulmonary function monitoring systems, blood gas analyzers, cardiac monitors, and intracranial pressure monitors. Additionally, wireless communication systems allow nurses to communicate directly with each other while providing care, bedside computer terminals allow nurses to record and analyze client data, and personal digital assistants (PDAs) allow nurses to record information and consult references.

The electronic health record (EHR) is a method of documentation where all information related to the client is recorded electronically. EHRs are legible, organized, and accessible. EHRs can be used to record laboratory results, schedule appointments, order medications, and individualize discharge planning.

Expert systems (decision-making support systems) can alert the nurse to abnormal diagnostic tests, warn the nurse about medication incompatibilities, remind the nurse when a medication is overdue, generate an appropriate list of nursing diagnoses, modify a standard care plan, find clinical guidelines, plan client education programs, and plan a client’s discharge.

An ethical issue when using computerized systems is the possibility of breeching client confidentiality. Privacy is assured by (1) installing a firewall, a protective mechanism that establishes limited access into a computer system; (2) limiting access by assigning passwords to those who are authorized to access the system; (3) backing up data and storing it in inaccessible locations; (4) physically placing computers in a secure area; (5) providing closed-circuit television surveillance of computers; and (6) automatically recording when an activity occurs to discover the point of origin of altered, lost, or incorrectly used data. When working with an EHR, the nurse should remember the principles for legal documentation: Document the correct information on the correct client, and sign the record appropriately.

Health care providers in ambulatory care settings (clinics, physicians’ offices, surgical centers, and dialysis units) are often satellites within a hospital network and can access EHRs as part of the interdisciplinary care team for the purposes of prescribing, scheduling tests and appointments, or recording information related to a visit. Computer technology facilitates the cross settings use of a care map, a plan of care based on standards that reflects optimal timing of sequential steps provided by all members of the health care team or managing chronic health problems.

Similarly, nurses working in the home and the community can use computer technology to access client records, enhance decision making, and communicate with others on the health care team. Nurses working in telephone triage (provision of health-related information to community and rural clients) use computerized databases to ensure that they provide standardized health information. Through the use of cellular phones and electronic mail (e-mail), nurses can communicate progress reports among health team members. Using portable computers and specialized monitors, they can (1) document client information, (2) set up and deliver a plan of care, (3) receive data from home care monitoring devices such as cardiac monitors or cardiac pacemakers, (4) monitor the progress of women going through a high risk pregnancy, (5) track client progress with an automated telephone monitoring system, and (6) link to emergency response systems used by the elderly.

A major trend since the 1950s is the development of telehealth, telemedicine, and telenursing services. Through these applications, clients can manage their blood pressure or diabetes, send results to their health care providers, access instruction, communicate with their health care providers, and communicate by e-mail, resulting in improved client participation in care and communication with health professionals. A major obstacle to the further development of these activities is lack of funding.

Several advances in biotechnology have revolutionalized medical care. Examples include magnetic resonance imaging (MRI), computed tomography (CT), electromyography, arthroscopies, the computerized microscope, and digital cameras. The research and development of these technologies has been quite expensive, leading insurers and the federal government to introduce cost control strategies.

Nurses have used computer technology in several roles. For example, nursing care managers use computer information systems to plan care, monitor the chronically ill, and provide client education. Community Health Information Networks (CHINs) permit access to a client’s EHR by authorized personnel from various community agencies, which facilitates the organization of care. A smart card, a computer disk for carrying information, provides information about insurance coverage, emergency care, and electronic address information to obtain access to the client’s health care record for information about medications and health history.

Nurse managers use word processing, spreadsheets, presentation programs, e-mail, and other programs to monitor care, maintain personnel files, inventory supplies, make decisions, and plan activities within their departments. Nurses with specialty certificates in nursing informatics (information technologies used by nursing) are experts in the use of computer technology.

Nurse educators use computer-assisted instructional (CAI) programs, audio-visual presentations, distance learning, and video conferencing to present educational material. They also use visual learning laboratories that teach monitoring of physiological data, charting, diagnostic studies, and so on. Advanced technology is also used in the research process. Nurse researchers use computer applications to conduct literature searches, analyze data, and network with other researchers.

One of the effects of technology has been the development of classification systems for nursing language, particularly as related to nursing diagnoses, interventions, and outcomes. The American Nurses Association developed the Unified Nursing Language System (UNLS) in 1991 to identify common nursing terms from a variety of vocabularies. The four classifications are the North American Nursing Diagnosis Association (NANDA), the Omaha Classification System (OCS), the Home Healthcare Classification (HHC), and the Nursing Interventions Classification (NIC).

Balancing the use of advanced technology with the traditional caring aspects of nursing is a challenge for modern nursing. Technological advances cannot make up for the presence and touch of a nurse or for the unique communication between client and nurse. Nurses who are adept at using technology to supplement caring and critical thinking are able to positively affect client outcomes and to participate fully as members of the health care team.