Dr. Leanne Currie
Co-Director of Research, CNIA
Dr. Éric Maillet
Co-Director of Research, CNIA
Even before the COVID-19 pandemic, virtual care was increasing across Canada as nurses explored new ways to engage with patients and their families and to support safe, high-quality patient care. The results from the 2020 National Survey of Canadian Nurses: Use of Digital Health Technology in Practice, however, suggest that further opportunities for improved patient care remain.
The online survey was conducted jointly from January to March 2020 by the Canadian Nursing Informatics Association (CNIA), Canada Health Infoway, and the Canadian Nurses Association (CNA). A total of 1,642 nurses took part in the study, 1,132 of whom provided direct patient care.
Full electronic systems enable higher quality of care
Of the nurses surveyed, 27% were working in fully-electronic systems. These nurses reported more satisfaction and improved quality of care than those working in hybrid environments, which are often a mix of paper charts and electronic records systems.
Other benefits revealed when comparing nurses using fully-electronic systems to those using hybrid systems:
- 85% reported increased access to complete patient information (versus 70% for hybrid);
- 68% reported improved continuity of care (versus 53% for hybrid);
- 69% reported improved care team communication (versus 51% for hybrid); and
- 63% reported improved quality of patient care (versus 50% for hybrid).
When asked to identify the main barriers to achieving full value from electronic systems, six key areas were identified. Each is more likely to be experienced in hybrid paper-electronic workplaces:
- 40% reported redundant data capture;
- 38% reported the use of hybrid systems;
- 25% reported issues with multiple logins;
- 25% reported multiple systems in use;
- 24% reported lack of available equipment; and
- 18% reported lack of appropriate training.
Nurses also reported that they continue to experience increased administration burden (45%), which can be a contributing factor to nurse burnout and adverse events. It’s important to consider these issues as new clinical information systems are built and implemented.
Virtual care is on the rise, but further training is needed to support nurses in using virtual care
Compared to the 2017 survey, the 2020 edition found that rates of virtual care adoption among nurses have increased.
- 36% facilitate e-visits using secure email (versus 25% in 2017);
- 27% consult directly with patients via virtual videoconference (versus 24% in 2017);
- 29% conduct virtual visits with a remote clinical provider while in-person with a patient (versus 23% in 2017); and
- 34% have patients under their care enrolled in remote telemonitoring services, such as Telehomecare (versus 26% in 2017).
As more nurses employ virtual care tools, more resources are needed to support both the nurses and the systems they use. The survey found that only 6 in 10 nurses who use virtual care technologies agreed they had the knowledge and skills required to use these technologies, demonstrating the need for further education and support.
As more nurses employ virtual care tools, more resources are needed to support both the nurses and the systems they use.
A barrier-free future for Canadian nurses
“We’re pleased to see the increases in the proportion of nurses practising in fully-electronic systems and delivering virtual care,” says Glynda Rees, President of the CNIA. “These technologies provide numerous benefits to nurses and their patients, and we need to continue to ensure that nurses have appropriate systems to support their work as well as the knowledge and skills to use them.”
The 2020 National Survey of Canadian Nurses provides a rich data set to explore the relationships between burden, burnout, and digital tools. It also demonstrates that, while such tools are a benefit to the health care system, proper training and support will be necessary to ensure Canadian nurses are able to use them effectively.
“The CNIA is ready to work with everyone in the health care system to eliminate barriers to use and enable the full contribution of nurses in the health care system,” says Rees.
“To transform our health care system based on evidence, we need, more than ever, to provide nurses with the best technologies in all care settings in order to support the particularities of their professional practice and thus to make a significant difference for patients and their families,” say Leanne Currie and Éric Maillet, Co-Directors of Research at the CNIA.