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AN

ESSAY

ON

SOCIAL, ETHICAL, AND LEGAL ISSUES IN NURSING INFORMATICS

WRITTEN BY

ORDU VICTORIA UWAJI

21/02245136

DEPARTMENT OF NURSING SCIENCE

FACULTY OF ALLIED MEDICAL SCIENCES

UNIVERSITY OF CALABAR, CALABAR

SUBMITTED TO

DR NDUKAKU NWAKWUE

DEPARTMENT OF NURSING SCIENCE

FACULTY OF ALLIED MEDICAL SCIENCES

UNIVERSITY OF CALABAR, CALABAR

IN PARTIAL FULFILMENT OF THE COURSE REQUIREMENT IN NSC 371

(NURSING INFORMATICS)

JULY, 2024
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Social, Ethical, and Legal Issues in Nursing Informatics

Introduction.

Nursing informatics is an important and rapidly evolving field that integrates nursing

science, computer science, and information science to manage and communicate data,

information and knowledge in nursing practice.Thus, nursing informatics also refers

to those collected informational technologies which concern themselves with the

patient care decision-making process performed by health care practitioners. Nursing

informatics is the specialty that integrates nursing science, computer science, and

information science in identifying, collecting, processing, and managing data and

information to support nursing practice, administration, education, research, and

expansion of nursing knowledge (American Nurses Association, 1994). This

interdisciplinary domain is very necessary for improving healthcare quality,

enhancing patient outcomes, and advancing nursing practice. However, there are

certain significant social, ethical, and legal issues that arise with integration of

informatics in nursing and must be carefully addressed to ensure the integrity,

security, and ethical use of health information.

Social Issues

Nursing informatics application has greatly changed the look of patient care and

interaction. Electronic Health Records (EHRs), and other digital tools have

straightened many nursing processes, which allows more efficient and accurate

documentation, data retrieval, and communication. the dependence on digital tools

can sometimes reduce face-to-face interaction between nurses and patients, which

affect the quality of the nurse-patient relationship and patient satisfaction (McGonigle

& Mastrian, 2017). Another critical social issue is the digital divide. This divide can
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lead to inequality in healthcare delivery and outcomes, particularly in under-served or

rural communities where access to digital tools and the internet may be limited

(Kumar & Mohapatra, 2020).

Ethical Issues

One of the principal ethical concerns in nursing informatics is to ensure patient

privacy and confidentiality. The digitization of health records and the widespread use

of electronic communication increase the risk of unauthorized access and data

breaches. Nurses must therefore stick to ethical principles in order to protect all

patient information, ensuring that data is only used appropriately with authorized

personnel (Hebda & Czar, 2019). Information sharing by nursing professionals with

unapproved parties is prohibited (eg: nurses who do not give care to the patient) and

lawsuits can result from their inadvertent breaking of the law. Furthermore, they are

unable to communicate in public spaces like elevators and hallways where others may

hear them. Particular ethical issues need to be taken into accountability. Another

ethical issue is the use of patient data and informed consent. Nurses also play an

important role in educating patients about their rights and making sure that their

consent is obtained ethically and transparently (McBride, Delaney, & Tietze, 2019).

Patients must be fully informed about how their data will be used, stored, and shared,

and they must provide consent to these processes.

Legal Issues

Nursing informatics is governed by various regulations and standards set to protect

patient information and ensure its ethical use. The Health Insurance Portability and

Accountability Act (HIPAA) in the United States sets stringent standards for the

protection and confidential handling of health information, including electronic health

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records (EHRs). These set regulations mandate healthcare personnel to implement

security measures to safeguard patient data against illegal access and threats.

Additionally, patients are being granted with rights over their health information,

medical records and request corrections to inaccuracies by HIPAA. Beyond HIPAA,

similar regulations exist in other countries, such as the General Data Protection

Regulation (GDPR) in the European Union, which emphasizes data protection and

privacy on a broader scale. Nurses need to have basic knowledge about these laws and

stay updated with any changes or new regulations to ensure compliance.

Furthermore, strict adherence to these rules is necessary to protect patient rights and

maintain trust in the healthcare system (Sewell, 2019). Ensuring compliance also

involves ongoing education and training for nursing staff to remain vigilant about data

security and privacy practices. Nurses must continue to upgrade their skills and

knowledge and also apply diligence in the use of informatics tool, maintain accurate

documentation in order to reduce risks of mistakes and legal issues (Gassert, 2008).

Nancy J. Brent, a writer, columnist, attorney, and nurse, compiled a list of crucial

legal considerations for health informatics professionals in a 2013 post for the HIMSS

website. These considerations amounted to a few main pointpatient safety must be the

top priority for a health in management team, protocols for health information

management must be established, and team members must be trained on these

policies, patient data must be held as securely as possible, and passwords of other

login information must never be shared among team members. Lastly, protection of

patient rights and progress toward better health outcomes using electronic technology

depend on the depth of knowledge front-line health informatics professionals bring to

their jobs.
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Reflective Learning Experience

I have gained a keen understanding of the different challenges and opportunities that

this field presents when studying the course. Reflecting on Patricia Benner’s work

"From Novice to Expert" and Donald Schön’s "The Reflective Practitioner," has made

me appreciate the importance of learning and reflective practice in nursing

informatics. This model inclines with my knowledge in nursing informatics, having

moved from basic familiarity with digital tools to more in-depth understanding of its

application in patient care. The stages of skill acquisition described by Benner are

evident in my journey as I have learned to embrace informatics in my practice.

Moreover, Schön’s concept of the reflective practitioner has been key in shaping my approach

to nursing informatics. Application of this in nursing informatics evaluate how digital tools

and technologies affect patient care, ethical standards, and professional competencies.

experiences with informatics. For instance, I have mastered the art of admiting the limitations

and potential biases of certain technologies, which has helped me in making and seeking out

more profitable and effective solutions. Reflecting on specific instances where digital tools

either enhanced or hindered patient care has allowed me to adapt more to new technologies

and ensure that my practice is both patient-centered and ethically sound. Schöns emphasis on

"reflection-in-action," where practitioners think on their feet, and "reflection-on-action,"

where they contemplate their experiences to improve future practice aligns with this process

of critical reflection (Schön, 1983).

Additionally, by applying insights from Benner's work on skill acquisition, I

recognized the importance of developing from novice to expert through reflective

practice. This is important in mastering the various issues that can arise in nursing

informatics which will help enhance patient care (Benner, 1982). The integration of

nursing informatics requires a commitment to ongoing education, ethical vigilance,

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and reflective practice. By accepting these principles, I am equipped to steer the

social, ethical, and legal challenges of informatics and to enhance the quality of care

being provided to my patients.

Conclusion

Nursing informatics is a life changing discipline that offers great benefits for

healthcare delivery and patient outcomes. However, there are certain complex social,

ethical, and legal challenges that must be carefully managed. Nurses must be vigilant

in protecting patient privacy, ensuring informed consent, and complying with

regulations. Through reflective practice and continuous learning, these challenges can

be steered and the full potential of nursing informatics use. Nurses can effectively

merge informatics into their practice, improving patient care and further the

profession by way of ongoing education and ethical practice.

References

1. Benner, P. (1982). From Novice to Expert. The American Journal of Nursing,

82(3), 402-407. http://www.jstor.org/stable/3462928

2. Hebda, T., & Czar, P. (2019). Handbook of informatics for nurses and healthcare

professionals (6th ed.).pearson.

3. Gassert, C. A. (2008). Technology and informatics competencies. In Nursing

informatics and the foundation of knowledge (pp. 223-236). Jones & Bartlett

Learning.
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4. McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and foundation of

knowledge (4th ed..). Jones & Bartlett Learning.

5. Kumar, S., & Mohapatra, S. (2020). Health disparities and the digital divide. In

Telehealth and mobile health (pp. 55-68). Springer.

6. McBride, S., Delaney, J. M., & Tietze, M. (2019). Nursing informatics for

advanced practice nurse: Patient safety, quality, outcomes, and

interprofessionalism (2nd ed.). Springer Publishing Company.

7. Schön, D. A. (1983). The reflective practitioner: How professionals think in action.

8. Choles, M., & Barber, B. (1980). Towards nursing informatics. In D. A. B.

Lindberg & S. Kaihara (Eds.), Medinfo 1980 (pp. 70–73). North-Holland.

9. Sewell, J. (2019). Informatics and nursing: Opportunities and challenges (6th ed.).

Lippincott Williams & Wilkins.

10. American Nurses Association. (1994). The scope of practice for nursing

informatics (ANA publication NP-907.5M 5/94). Washington, DC: American

Nurses Association.

11. Finkelman, A., & Kenner, C. (2013). Professional nursing concepts. Burlington,

MA: Jones and Bartlett Publishers.

12. HSF Health Online. (2024). Legal and ethical issues in health informatics.

Retrieved from https://www.usfhealthonline.com/resources/health-informatics/legal-

and-ethical-issues-in-health-informatics/
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