The advent of information technology has revolutionized various aspects of contemporary societies. The administration of healthcare has equally been revolutionized by its incorporation of information technology in the development of health records and Nursing informatics. The major advantage about this system relates to the storage of large volumes of clinical and information about patients, which helps nurses and other healthcare practitioners to access patient information with ease (Dexter, Perkins, Overhage, 2012) . Therefore, electronic health records (EHR) have greatly enhanced healthcare provision and entire clinical processes. Furthermore, it has eased the process of information sharing among clinicians and health caregivers ( Menachemi, Prickett, & Brooks, 2011) . Therefore, the advantages of the electronic health record, as well as nursing informatics, cannot be overemphasized. However, the usage is associated with various limitations ranging from ethical, legal to professional concerns in the nursing profession. Therefore, it is imperative to understand such limitations and compare them with the potential advantage in deciding on whether or not to employ electronic health records.
The use of EHR has high-cost implications. The cost of purchasing nursing informatics software as well as other electronic health records is relatively high. Consequently, health facilities have to spend more funds on purchasing such software. Moreover, the cost of training the staff and potential losses due staff errors in the initial stages of implementation serves to make this system more expensive. Furthermore, the cost of the maintenance of the system is equally high. The average cost of maintaining a simple electronic health record system is about US$8000 annually including the cost of hardware replacement as well as vendor support services ( DesRoches et al., 2010) . The effect of this is that the healthcare administrators pass the cost to the patient. It makes the cost of healthcare more expensive than it should ordinarily be. An effective healthcare system is one that makes health care affordable to every person (Dexter, Perkins, Overhage, 2012) . An increase in the cost of healthcare makes it hard for low-income earners within the society to access quality healthcare. Therefore, EHRs makes the healthcare ineffective in reaching out to the healthcare needs of the majority of the population.
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Using EHR provides an avenue for violation of patient privacy. A patient shares significant personal information with their clinicians and healthcare givers. EHRs make it possible for this information to be shared among a large number of people within the healthcare facility. Consequently, this system provides a risk of exposing personal health information about a particular patient to other people who are not part of the treatment process and who should ordinarily not access such information ( Agrawal & Wu, 2014) . Unfortunately, it violates the ethical requirement by all healthcare providers to maintain the privacy of their patients. Whereas several legislations have been put in place to safeguard the privacy of patients particularly in the using EHR sand nursing informatics, there is an opportunity for such violations. Such legislation seeks to protect patient privacy by limiting information sharing through electronic platforms. For instance, such legislation requires the system to report any person who accesses a patient’s records ( DesRoches et al., 2010) . The strategy helps the healthcare facilities to monitor patient information sharing within the healthcare facility and eliminate unnecessary sharing of such information. However, these legislations have not resulted into a watertight system that eliminates the possibilities of patient privacy violations.
Moreover, EHR usage also caused instances of medical errors that negatively affect the effectiveness of the healthcare system. These errors have largely been attributed to the poor user interface. The makes the information input into the system to be erroneously interpreted leading to wrong medication, clinical procedure, and nursing processes. Moreover, errors in the use of such systems equally occur due to poor training of the health caregivers on the use of the system. It is imperative to note that healthcare providers have no background knowledge. When such errors occur, patients are misdiagnosed and given wrong medication and healthcare, which compromises the overall integrity of the healthcare system.
It is important to acknowledge the great advantage that the use of information technology has brought to the practice of healthcare particularly regarding the accuracy of medication. Systems such as barcoding in medication administration, electronic health records, automated medicine dispensation and computerized physician entry have played a critical role in preventing human errors in medication and therefore enhanced the accuracy of medication (McCullough, Casey, Moscovice, & Prasad, 2010) . For instance, barcoding in medical administration helps the nurse to ascertain the type of medicine given to any patient. The nurse scans the patient’s code and it the dose being administered. The system notifies the nurse if there is a mismatch between the identity of the patient and the dose being administered. The nurse can ascertain if he is administering the right drug at the right dose at the right time to the right patient and through the right route ( Agrawal, & Wu, 2014) . As a result, bar coding enhances the accuracy of medication by eliminating possibilities of error.
Automated pharmacy dispensing systems use the concept of barcoding. The medicines are identified through barcodes by the automated dispenser before the patients take. Before the use of barcoding in the electronic identification of medicine, the rate of wrong medication was very high. The consequences of such wrong medication are greatly severe to the patient. However, the institution of information technology use in medicine identification has greatly helped in the reduction of such errors in dispensing medicine.
Nursing informatics has greatly revolutionized the practice of nursing and created diverse roles for nurse other than their traditional roles. The use of informatics is becoming a critical component in the context of healthcare practice. Presently, nurses should have basic knowledge of informatics systems such as electronic health records and automated medicine dispensation medication (McCullough, Casey, Moscovice, & Prasad, 2010) . Consequently, new roles for the nurses are also emerging such as monitoring electronic patient data and incorporation of aspects of information technology in their daily healthcare provisions to their patients. Moreover, nurses are also required to communicate data about their patients to other clinicians over information technology platforms. The nurses present information and retrieve information about patients over electronic media that enhance the efficiency of the healthcare that they provide. Most significantly, informatics has changed the documentation roles for the nurses ( DesRoches et al., 2010) . Instead of maintaining written records and notes, nurses now input such records over electronic platforms.
The evolving roles of nurses in the phase of informatics has equally resulted in the creation of new career lines that border between nursing and information technology. They include clinical information specialists, nursing analysts, clinical information coordinator, nursing information specialist and nursing informatics analysts. Due to the nature of nursing, it has become important for the development of careers that involve nurses in information technology. The nursing background knowledge facilitates the development, customization, and management of informatics in a way that is relevant to the nursing profession.
The use of information technology in nursing has hindered and advanced nursing and overall healthcare in equal measure. The main advancement in healthcare that has come due to the use of information technology is the improvement of accuracy in medication and nursing. The use of technology platforms such as barcoding and automated dispensation has helped to enhance accuracy in nursing ( DesRoches et al., 2010). Secondly, nurses can access information about a particular patient instantly when using informatics. Eventually, it helps the nurse to make a quick judgment about patients in the process of nursing.
The ease associated with information technology platforms on patient management helps the nurses to fast track their clinical needs and the specialized nursing requirements ( Menachemi, Prickett, & Brooks, 2011) . On the contrary, information systems have taken much of the nurses’ time to the extent they no longer deliver on their core responsibilities in nursing. Moreover, the complications of such systems render nurses who do not have any background in information technology or basic computer skills ineffective in giving health care services to patients while working in an environment of informatics. Therefore, the use of information technology has come with both merits and challenges.
Overall, the electronic health records and nursing informatics has greatly affected the practice of nursing and its overall effectiveness. The major advantage of EHRs relates to the ability it presents in storing large volumes of patient data and quick access to specific patient data. Moreover, the ease of information sharing among clinicians has been occasioned by the use of information technology. However, this system has come with both ethical as well as legal challenges. The major ethical challenge is in the violation of patient privacy that such systems enable. Moreover, it has brought about the stringent legal requirement in such systems that are a challenge in compliance. However, informatics has contributed to enhancing the accuracy of medication and eliminated any potential error. Lastly, informatics and electronic health records have greatly altered the traditional roles of a nurse.
References
Menachemi, N, Prickett, C. & Brooks, R. (2011). The use of physician-patient email in Florida 2005–2008: a follow-up examination of adoption and “best practice” adherence. Journal of Medical Internet Research, 12 (1):e23.
Dexter PR, Perkins S, Overhage JM, et al., (2012). A computerized reminder system to increase the use of preventive care for hospitalized patients. New England Journal of Medicine, 345 (13): 965–970.
DesRoches CM, Campbell EG, Vogeli C, et al. (2010). Electronic health records’ limited successes suggest more targeted uses. Health Affairs (Millwood). 29 (4):639–646.
McCullough. JS, Casey. M, Moscovice. I., & Prasad S. (2010). The effect of health information technology on quality in US hospitals. Health Affairs (Millwood) 29 (4):647–654.
Agrawal, A & Wu W. (2014). Reducing medication errors and improving systems reliability using an electronic medication reconciliation system. Jt Comm J Qual Patient Saf . 2009; 35 :106–14.
