Posted on September 22, 2020 by Waldo Beauséjour
Nurses comprise the largest proportion of Canada’s health care providers. The most recent data from the Canadian Institute for Health Information (CIHI)’s Nursing in Canada, 2019 survey reveals that the regulated nursing workforce grew by 1.9 per cent from 2018: faster than the general Canadian population growth. This increase is welcome news, since nurses play a prominent role in patient care. A larger nursing workforce will support better access to health care for Canadians, especially during this unprecedented health crisis.
Whether they are delivering care or facilitating health care interventions, Canadian nurses work primarily in hospitals, nursing homes and community-based care settings. Many of these settings are moving towards modernized care delivery systems that hinge on digital health technologies. This technological shift is bringing about significant changes in nursing practice. Since 2014, Canada Health Infoway (Infoway), in collaboration with the Canadian Nursing Association (CNA) and the Canadian Nursing Informatics Association (CNIA), has been investigating how the implementation of digital heath technologies — especially electronic record systems and virtual care technologies — has impacted nursing practice across care settings. To our knowledge, this is the only national survey that collects data on the use of technology in nursing practice.
In 2020, more nurses are accessing electronic record systems, with 27 per cent working in fully electronic record-keeping environments: an increase from 20 per cent and 23 per cent in 2014 and 2017 respectively. These technologies are becoming integral to nursing practice, as suggested by the results of the 2020 National Survey of Canadian Nurses. The use of electronic records helps improve quality and continuity of care; access to them is therefore a key aspect of modern care delivery.
In the United States, providers receive federal incentives when they adopt electronic records, leading to massive adoption in the American health system. However, the use of hybrid and paper systems persists in Canada, which hinders nursing practice.
COVID-19 has also placed tremendous pressure on the nursing workforce, as nurses are at the forefront of the pandemic response. The pandemic has triggered a rapid virtualization of health care delivery, making it necessary to assess whether Canadian nurses are technologically prepared and equipped to deal with this situation.
The 2020 National Survey of Canadian Nurses does not directly answer this question, but it has given us a sense of the current state of the use of virtual care technologies by nurses. The results seem promising. Roughly two months before the pandemic was declared, almost one third of nurses indicated that they had delivered care through either a virtual video conference (27 per cent) or an electronic message using secure email (36 per cent), had facilitated an in-person visit with patients with remote clinical provider (29 per cent), or had enrolled patients in remote telemonitoring services (33 per cent). The proportion of nurses accessing virtual care technologies is much greater than we observed three years ago — it was between three to nine per cent in 2017. As virtual care continues to be deployed, it is necessary that nurses receive training in virtual care delivery to enhance their skills and competencies.
These increases in the proportion of nurses practicing in fully electronic systems and delivering virtual care reflect the efforts by nursing associations and allies to integrate technology into nursing practice. Nonetheless, there is still work to be done to address the barriers — especially lack of knowledge and skills — that prevent nurses from getting full value from digital technologies.
As more of our care is delivered virtually, supporting nurses in their use of technology is more important than ever. To learn more, be sure to join us on September 23 for our French-language webinar exploring results from the 2020 National Survey of Canadian Nurses (available in English here).
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Waldo holds a master’s degree in Applied Economics. He currently serves as Analyst, Performance Analytics at Canada Health Infoway. He has experience in applied social research and quantitative research methods for over 10 years. He has led and contributed to several quantitative surveys, research and impact evaluations aiming at investigating the impact of government-led or funded interventions on health outcomes.