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Best Practices for Using Technology & Social Media

Technology plays an integral role in managing patient care in today's modern healthcare environment. From scanning charts/medication to communicating via smartphones, there are many advantages to utilizing technology. At the same time, increased use of technology also brings potential issues that must be identified and mitigated in order to maintain the health and safety of patients.

Using technology safely in a healthcare environment

Technology has become an integral part of healthcare environments. Many nurses carry unit-specific phones to talk directly with patients or with other care providers about patient care issues. Some institutions have begun to use smartphones for nurses to text, e-mail or call physicians, or to access the Internet. In an effort to reduce medication errors, many institutions now use a system of bar-coding and scanning medications before they are administered.

Despite the many advantages of technology in the workplace, there are several potential disadvantages, including possible decreased patient safety, de-personalized care, breach of confidentiality, poor infection control and possible inappropriate behavior. Below, we examine these issues and discuss potential policies that should be established to create and maintain high-quality patient care delivery systems.

Potential disadvantages of technology in the workplace

1. Dangers of distracted caregivers

Designated unit-specific phones that are assigned to nurses at the start of shifts allow patients and other healthcare team members to call nurses directly. This can enhance communication among patients, nurses and other healthcare team members.

However, the unit-specific phones can also cause numerous interruptions when nurses are involved with tasks requiring concentration and focus. For example, what should a nurse do if the phone rings while a medication is being administered? Answering the phone while continuing the task could potentially cause a distraction and a possible medication error. A policy may need to be in place to allow the call to "rollover" to the nursing desk or for the phone to go to the nurse's voicemail until he or she is able to respond.

2. Decreased quality of interpersonal relationships

A Canadian study found that after the introduction of smartphones for medical residents, there was a perceived increase in efficiency of communication between physicians and nurses. However, there was also a perceived decrease in the quality of interprofessional relationships due to the overreliance on electronic communication. In addition, patients can perceive a lack of empathy and a sense of aloofness if caregivers focus more on electronic devices than on the patients themselves.

The healthcare environment has become increasingly high-tech instead of hands-on, yet it is important to remember to focus on the patient. Establishing a therapeutic relationship early by displaying empathy, respect and warmth and continuing to maintain this relationship with patients and family members is increasingly important as more technology is introduced into the healthcare environment.

3. Confidentiality issues

In one case, a nurse was observed talking on her unit-specific phone about a patient on the same unit while in front of another patient and her family members. The nurse was discussing a specific medical problem the other patient was having and although the patient's name was not mentioned, too many details were discussed. This conversation occurred while the nurse was flushing a central line. In addition to the dangers of making a mistake while completing a task with one patient, there was also the potential for a violation of patient confidentiality.

Another possible violation of patient confidentiality could occur when patient information is forwarded via an e-mail or text message to the wrong address or recipient. Hospitals and other healthcare systems considering implementing the use of smartphones within their facilities need to provide secure networks. This would prevent access to confidential information by those who have no clinical relationship with the patient.

Moreover, mobile electronic devices left unattended or poorly positioned could be read by individuals who should not have access to the health information displayed on the screen.

4. Infection control issues

One study revealed that 94.5% of healthcare workers' cell phones tested positive for bacteria including the methicillin-resistant strain of staphylococcus aureus (MRSA). Healthcare workers must understand the importance of hand washing before, after and in-between patient care. They must also be aware of the importance of hand washing when handling mobile devices and should implement routine cleaning of electronic devices to prevent the spread of nosocomial infections in the workplace. Routine cleaning of all electronic devices should be a component of hospital policy.

5. Inappropriate behavior

Many institutions have implemented policies to outline the appropriate use of technology in the workplace. These policies have been put in place to decrease the incidence of unprofessional behavior such as using personal electronic devices for personal reasons while working. The purpose of these policies is to promote quality patient care and safety.

With the increased use of social networking, many institutions have more recently found it necessary to create a policy on the use of social networking, public Internet and digital online postings. The goal of these policies is to protect patient health information and privacy, as well as the employer's proprietary interests and reputation.

While every hospital should work with their legal and human resources departments to create policies, here are some suggested policies to create a culture of safety.

Suggested policies for the use of mobile and other electronic devices in the workplace

  • ::  Personal cell phones should be turned off or in silent mode when in public areas.
  • ::  Personal texting or phone calls should take place only at breaks or meal times away from clinical areas.
  • ::  Employees who are involved in direct patient care should leave their cell phones with their personal items unless cleared by their supervisor.
  • ::  Employees who drive should under no circumstances text or talk on the phone while driving on company business.
  • ::  Photos or recordings with personal cell phones are prohibited.
  • ::  Phones issued by the institution and used in the patient care environment should be cleaned with an approved antimicrobial wipe at the beginning of each shift as well as before and after each patient contact.
  • ::  Nurses carrying unit-specific phones may choose to allow a call to rollover to the nursing desk if they're involved in direct patient care activities.
  • ::  The above policies are enforceable and may result in disciplinary procedures and possible dismissal for violations.

Suggested policies for the use of social networking, Internet and online posting

  • ::  Employees should refrain from sharing any information concerning patients or patient care activities through personal blogs, postings of videos or pictures, or responses made to comments made by other Internet users either publically or via e-mail.
  • ::  The employer has the right to block access to Internet sites on workplace computers and to monitor Internet and social media activity in the workplace.
  • ::  Social networking and Internet activities should be limited to breaks and meal times and should occur away from patient care areas.
  • ::  The employer has the right to ask the employee to remove social media postings that may reflect negatively on the institution.
  • ::  The above policies are enforceable and may result in disciplinary procedures and possible dismissal for violations.


By clearly incorporating proper policies and guidelines to address the issues outlined above, healthcare institutions can prevent potential problems associated with the use of technology in the workplace. Nurses have as much responsibility as other healthcare professionals to implement safe and effective behavior in relation to the use of electronic devices in the workplace.

The Leadership and Informatics in Professional Nursing course within the online RN to BS Nursing (RN-BSN) program at Utica College explores the impact of informatics and technology on nursing, patient care and health care delivery. This real-world, relevant curriculum recognizes that technology has become an integral part of nurses' daily work and incorporates education on the many benefits and potential pitfalls of its use.


Adapted from: Broussard, B.S. & Broussard, A.B. (2013) Using Electronic Communication Safely in Health Care Settings. Nursing for Women's Health 17 (1), 59-62. [WWW document] URL [accessed 4 July 2014]