Workforce Development Panel: OHIT Grantee Meeting

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Workforce Development Panel OHIT Grantee Meeting

• Diane J.Skiba, PhD
• University of Colorado at Denver Health
  Sciences Center
• Tuesday November 7, 2007 315-500

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Goals

• To identify challenges to meet the growing demand
  of HIT adoption
• To determine how we provide informatics education
  and build capacity in the nursing workforce
• To identify strategies for preparing more
  informatics specialists

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Converging Forces

• Converging forces that are serving as a catalyst
  for transforming nursing practice.
• Federal Influences
• IOM Studies and Reports
• Emerging Technologies
• Consumer Demands including digital natives

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Are nurses Ready?

• Are nurses ready for data driven decisions and
  EBP?
• Are nurses ready for consumer centric care?
• Are nurses ready for informatics intensive
  environments?
• Are nurses positioned for this transformation?
• Perhaps the bigger question is
• Are nurse educators ready???????

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Computer literacy skills

• As defined by ANA Scope Standards of Nursing
  Informatics Practice, a set of skills that allow
  individuals to use computer technology to
  accomplish tasks. Tools such as word processor,
  databases, spreadsheets, email and other
  communication mechanisms.

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Computer Skills

• NLNAC defines technology literacy as the ability
  to effectively use IT systems , communication
  technologies, and sophisticated information
  management systems This also includes the
  ability to apply knowledge and skills in the safe
  use of medical devices in nursing practice.
• AACN identifies learning opportunities concerning
  the managing health-related data and using IT to
  provide nursing care. For the DNP, utilization
  of technology and information for improvement and
  transformation of health care.
• Barton, A. J. (2005). Cultivating informatics
  competencies in a community of practice. Nursing
  Administration Quarterly, 29(4), 323-328.

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ANA Scope Standards

• Beginning Nurse
• Computer Skills - Administration
• Computer Skills - Communication
• Computer Skills - Data Access
• Computer Skills - Documentation
• Computer Skills - Education
• Computer Skills - Monitoring
• Computer Skills - Basic Desktop Software

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Computers Skills

• European Computer Driving License Foundation
• http//www.ecdl.com/publisher/index.jsp
• International Computer Drivers License
• http//www.acs.org.au/icdl/
• Essential IT Skills (ECDL)
• http//www.ecdl.nhs.uk/

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Information Literacy Skills

• Association of Colleges and Research Libraries
  (2000) define as set of abilities allowing
  individuals to recognize when information is
  needed and to locate, evaluate and use that
  information appropriately. Primary focus is on
  information access and evaluation.

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An information literate person can

• Determine the extent of information needed
• Access the needed information effectively and
  efficiently
• Evaluate information and its sources critically
• Incorporate selected information into ones
  knowledge base

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An information literate person can

• Use information effectively to accomplish a
  specific purpose
• Understand the economic, legal, and social issues
  surrounding the use of information, and access
  and use information ethically and legally
• (ACRL, 2000, p2.)

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Are nurses ready for EBP?

• Pravikoff, Pierce, Tanner (2005).
  Evidence-based practice readiness study supported
  by AAN Expert Panel. Nursing Outlook, 53
  (1),49-50.
• Pravikoff, Tanner and Pierce (2005). Readiness
  of US Nurses for EBP. AJN, 105 (9), 40-51.

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Are nurses ready for EBP?

• National Survey of RNs
• Focus was to examine nurses readiness to engage
  in EBP which included
• Awareness of a need for information
• Ability to identify needed information
• Ability to search available resources
• Ability to apply the information or evidence in
  practice

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Are nurses ready for EBP?

• 1097 nurses (37) response rate
• 94 female 80 over 40 years old and 72
  receiving their most recent degree prior to 1995

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Are nurses ready for EBP?

• Most frequent source of information is colleague
  or peer
• 34 felt they needed information only seldom or
  occasionally
• Almost half were not familiar with the term EBP

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Are nurses ready for EBP?

• Our conclusion is that RNs in the United States
  arent ready for evidence-based practice because
  of the gaps in their information literacy and
  computer skills, their limited access to
  high-quality information resources, and above
  all, the attitudes toward research.
• Pravikoff, Tanner Pierce (2005) AJN

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Educational Testing Services

• Information and Communication Technology Literacy
• iSkills test
• http//www.ets.org/

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Informatics Skills

• ANA Scope of Practice
• Scope and Standards of Nursing Informatics
  Practice (2001). Washington, DC American Nurses
  Association.

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ANA Scope of Practice

• Beginning Nurse
• Fundamental information management and computer
  literacy skills.
• Use existing informatics solutions and available
  information to manage their practice.

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ANA Scope of Practice

• Beginning Nurse
• Identifying, collecting and recording data
  relevant to the nursing care of patients
• Analyzing and interpreting patient and nursing
  information as part of the planning for the
  provision of nursing services
• Using informatics applications designed for the
  practice of nursing.
• Implementing public institutional policies
  related to privacy, confidentiality and security
  of information.

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ANA Scope of Practice

• Experienced Nurse
• Proficiency in one of more domains of interest.
• Highly skilled in information management
  communication
• Have information and computer literacy skills to
  support their major area of practice.
• See relationships among data elements and make
  judgments based on trends and patterns within
  these data.
• Use current informatics solutions but collaborate
  with INS to suggest improvements.

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ANA Scope of Practice

• Experienced Nurse
• All beginning nurse competencies plus
• Use system applications to manage data,
  information and knowledge in their specialty area
• Participate as a content expert to evaluate
  information assist others in developing
  information structures and systems to support
  their area of nursing practice.
• Promote the integrity of and access to
  information to include, but not limited to,
  confidentiality, legal, ethical and security
  issues.

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ANA Scope of Practice

• Experienced Nurse
• - Being actively involved in efforts to improve
  information management and communication (I.e.
  supports the development and use of standardized
  nursing languages).
• - Acts as an advocate or leader for
  incorporating innovations and informatics
  concepts into their area of specialty.

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NLN faculty and Deans survey

• Electronic Survey sent to Deans/ Directors and
  faculty not just NLN Schools
• Respondents
• 549 Deans/Directors
• 1557 Faculty

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NLN Faculty and Dean Survey

• Computer Requirement-No
• PDA Requirement-No
• Computer Literacy Requirement-50
• Information Literacy Requirement
• Deans 39
• Faculty 60

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NLN Faculty Deans Survey

• Confusion on the meaning of informatics
• Inclusion of informatics in the curriculum tend
  to fall into several categories
• Exposure in the Clinical
• Library
• Some content, more likely in BS or graduate
  courses
• students take online courses

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Essentials of Baccalaureate Education AACN
(under review)

• Essential IV Nursing Informatics and Patient
  Care Technology within the Practice of the
  Baccalaureate Generalist
• Use IT and patient data for clinical decision
  making
• Use technologies that facilitate clinical care
• Evaluate technologies used in patient care
• Protect privacy of patients relative to IT
• Use safeguards in IT and IS to create safe
  environment
• Demonstrate knowledge of regulations for using IT
• Use technologies to assist in effective
  communication
• Develop awareness that new technology requires
  new workflow and changes in practice

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Doctorate of Nursing Practice

• Essential 4 Information Systems/Technology and
  Patient Care Technology for the Improvement and
  Transformation of Health Care
• Design, select, use and evaluate programs the
  evaluate and monitor outcomes including consumer
  use
• Analyze and communicate critical elements in
  selection, use and
• evaluate HIT
• Demonstrate conceptual ability and technical
  skills to develop and
• execute an evaluation plan including data
  extraction
• Provide leadership in resolution of ethical
  issues related to use of HIT
• Evaluate health information sources for accuracy,
  timeliness, and appropriateness.

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Challenges
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Solutions-Exemplars

• Present
• University of Kansas/Cerner Partnership
• Johns Hopkins University/Eclipsys Partnership
• University of Colorado Denver HSC/McKesson
  Partnership
• Ohio State University/CliniComp
• Future
• And the list is growing

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KU and Cerner

• Simulated E-hEalth Delivery System (SEEDS)
  Project
• Academic Education Solution which utilizes
  clinical information systems throughout the
  curriculum
• Evidenced Based approach to learning
• Joint development of clinical academic content
• Promotes critical decision making skills
• Enhances students access to state of the art
  technology
• Utilized by Nursing and Medical students

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Educational Exemplars

• St. Scholastica College of Nursing Allied
  Health
• University of Utah
• Dr. Carole Gassert
• University of Maryland
• Dr. Judith Ozbolt

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Exemplars

• Johns Hopkins University and Eclipsys Corporation
• Working to Re-engineer Nursing Curriculum with
• Clinical Information Technology
• The goals of the partnership
• To increase the healthcare information technology
  
• competence of nursing graduates and to design new
  ways of delivering safe and efficient healthcare
  utilizing healthcare information technology
• 37 beds in three simulated SON labs integrated
  with technology
• Curriculum plan encompasses use of CIS systems
• Vested resources (implementation teams, project
  managers etc)

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Exemplars

• University of Colorado at Denver Health Sciences
  Center and McKesson Corporation Partnership
• CD-ROM Development Project
• University Hospital and Simulation lab
• RW Johnson QSEN Project

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Educational Exemplars

• Mt Aloysius College
• Dr. Janet Grady
• Virtual Practicum
• Walter Reed Ft. Sam Houston
• Telehealth Experience

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Educational Exemplars

• Columbia University
• Informatics Integration in NP Program
• PDA development
• Clinical E- Logs
• Nursing Terminologies

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OSU and Clinicomp

• To give nursing students a real-world experience
  .
• Develop their nursing skills in using technology
  in practice
• Embedding informatics knowledge into existing
  medical/surgical curriculum
• Educating faculty, students and practicing nurses
  about informatics
• Improving access to mobile or POC devices

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Strategies for Faculty Development

• HRSA Funded Projects
• AMIA 10 x 10 Program
• WINI Seminars
• AHIMA/AMIA
• TIGER Initiative
• NLN Faculty Development TG

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HRSA

• Faculty development
• Informatics and Educational Technologies
• Duke University
• http//www.nursing.duke.edu/page/full/191
• University of Wisconsin-Madison
• University of Pittsburgh
• HITs Collaboration KU, IUPUI, UCDHSC NLN
• http//www.HITS-colab.org

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AMIA 10 x 10 Program

• http//www.amia.org/10x10/

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WINI

• Weekend Immersion in Nursing Informatics
• http//www.winiconference.net/
• This conference focuses on trends and issues in
  practice facing the profession and provides a
  comprehensive examination of nursing informatics
  theories, impact of human factors, systems life
  cycle approach, methods for managing information
  databases and information technology overview.

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Building the Work Force

• For health Information Transformation
• AHIMA and AMIA
• http//www.ahima.org/emerging_issues/Workforce_web
  .pdf

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Building the Work Force for HIT

• As the transition to an electronic record gains
  momentum, healthcare delivery will need to
  dramatically reinvent the way it collects,
  processes and uses health information. It will
  require an investment in capital, time and
  resourcesmost importantly investment in people.

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Building the Work Force for HIT

• A work force capable of innovating, implementing
  and using health communications and information
  technologies will be critical to healthcares
  success.

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Technology Informatics Guiding Educational Reform
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TIGER Vision

• Allow informatics tools, principles, theories and
  practices to be used by nurses to make healthcare
  safer, effective, efficient, patient-centered,
  timely and equitable
• Interweave enabling technologies transparently
  into nursing practice and education, making
  information technology the stethoscope for the
  21st century
• http//www.tigersummit.org

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NLN Faculty Development TG

• To formulate a comprehensive plan for faculty
  development related to the integration of
  informatics into the nursing curriculum.
• Examine exemplars innovative approaches
• Develop curriculum guidelines
• Develop web resources
• Develop comprehensive faculty development plan
• E- Community sessions

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Preparation of Informatics Specialists

• AMIA Think Tank
• Educational Programs
• HIMSS 2007 Survey
• Faculty Open Positions

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HIMSS 2007 Survey
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Challenges

• Faculty Need
• Identification of Competencies
• Nursing Agenda to prepare all nurses
• Next Generation
• Current Nursing Staff
• Recognition of Nursing Contributions
• Continued Funding
• Virtual Demonstration Center
• Academic-Vendor Partnerships
• Academic-Heath Care Partnerships
• Interdisciplinary Efforts

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Questions and Answer session
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Thank you!!!

• Diane.Skiba_at_uchsc.edu
• University of Colorado at Denver Health
  Sciences Center