Nursing Informatics

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Nursing Informatics

• Dr. Belal Hijji, RN, PhD
• November 28 29, 2010

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Learning Outcomes

• At the end of this lecture, students will be able
  to
• Identify the various roles that computers play in
  nursing education, practice, management, and
  research.

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COMPUTERS in NURSING EDUCATION

• Computers are used extensively in nursing
  education libraries are computerised, nursing
  educationalists use computers in classroom
  teaching and for academic record keeping.
• In nursing education, computers are used in
  teaching and learning, testing, and student and
  course record management. Each of these are
  described next.

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Teaching and Learning

• Computers enhance academic performance for both
  students and faculty through facilitating access
  to literature, computer-assisted instruction,
  classroom technologies, and distance learning.
• Literature access and retrieval computers have
  significantly improved our abilities in keeping
  abreast of the information on any subject. In a
  fraction of time, continuously updated cumulative
  indexes of subjects can be searched
  electronically.
• Once a list of search matches is displayed on
  screen, the user can select all or certain
  citations and either print them or store them on
  the hard disk.

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• The text below lists commonly used bibliographic
  systems and databases.

Acquired Immune Deficiency Syndrome information
onLINE (AIDSLINE) CANCER LITerature (CANCER
LIT) Cumulative Index to Nursing and Allied
Health Literature (CINAHL) Educational Resources
Information Center (ERIC) Medical Literature
Analysis and Retrieval System (MEDLARS) Mental
Measurement Yearbook Psychological Abstracts
(PsychINFO)
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Computer-Assisted Instruction (CAI)

• Many software programmes help students and nurses
  learn and demonstrate learning. These include
  drug dosage calculation and ethical decision
  making.
• Examples of tutorials include ECG interpretation,
  drug interactions, and legal aspects of nursing.
• Completion of CAI programmes may be an acceptable
  means of demonstrating continuing education
  activities. For example, nursing faculty can
  obtain a certificate from the National Institute
  of Health (NIH) regarding the protection of human
  subjects in research.

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Classroom Technology

• New educational buildings are wired to
  accommodate technology. This includes electric
  outlets and wireless technology for network or
  Internet access.
• For nursing faculty, liquid crystal display (LCD)
  panels allow computer screens to be displayed to
  the entire classroom.

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Testing

• This is the second use of computer in nursing
  education.
• Surveys, including anonymous questionnaires, can
  be completed online.
• For testing, large banks of potential items can
  be written and the computer can generate
  different exams for each student depending on the
  selection criteria. Students answers can also be
  scored electronically and the exam results
  analysed quickly. For example, the National
  Council Licensure Examination (NCLEX-RN) moved
  from paper and pencil tests to computer tests.

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Student and Course Record Management

• Computers are useful for maintaining results of
  students grades or attendance, for example al
  Zajel. The computer programme can calculate
  percentages, sort student scores in order, and
  print results for both students and faculty.
• Students are frequently asked to evaluate faculty
  and courses. These data are also scanned into the
  computer so that cumulative results can be
  calculated and stored.
• Many schools have now all student records on
  computer. From application through graduation,
  the registrars office keeps track of names,
  addresses, courses taken, grades, and all other
  important data.

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COMPUTERS IN NURSING PRACTICE

• Computers help nurses collect, record, and use
  clients data.
• Nurses maintain clients data in computer
  records, assess other departments information
  about him/ her, and use computers to manage
  client schedules.

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Documentation of Client Status and Medical Record
Keeping

• Computer can help nurses in service in their
  daily activities by reducing the amount of time
  needed to record in the clients file, to access
  data about the client that may be somewhere in
  the file or elsewhere in the health institution.
• Computers can help nurses in accessing
  standardised forms, policies, and procedures.
• Within the context of the above title, we will
  discuss next bedside data entry, computer-based
  client records, data standardisation and
  classification, and tracking clients status.

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Bedside Data Entry

• Bedside data entry systems allow recording of
  client assessments, medication administration,
  progress notes, care plan updating, client
  acuity, and accrued charges.

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Computer-Based Client Records

• Computer-based patient record (CPRs) allow client
  data retrieval by caregivers, administrators,
  accreditors, and others who require the data.
• CPRs can improve a clients health in four ways.
• Constant availability of clients health
  information across the life span.
• Ability to monitor quality of care.
• Access to stored data.
• Ability of clients to share in knowledge and
  activities influencing their health.
• One of the concerns with the CPRs is maintaining
  a clients privacy and security of data, which
  can be protected by user authentication via
  password or retinal scans.

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Tracking Clients Status

• Once a CPR has been established, the nurse can
  retrieve and display a clients physiological
  parameters across time. For example, this
  includes vital signs.
• Standardised nursing care plans and care maps can
  be stored in the computer and easily placed in
  the CPR electronically.

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COMPUTERS in NURSING ADMINISTRATION

• Human resources Employers must maintain a
  database, computerised or not, on each employee.
  Data held about each employee include
  demographics, salary, life support certification,
  health requirements, and performance appraisals.
• Medical records management Medical records
  reflect costs. While it is expensive to keep
  records, it is even more expensive not to be able
  to access what is in them. Nurses, therefore,
  need to search client record for trends including
  most common presenting diagnoses, most expensive
  cases, length of stay, and client outcomes.

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• Facilities management Computers can facilitate
  many aspects of managing building and non-nursing
  services. This means that computers can control
  heating, air conditioning, ventilation, and alarm
  systems. Security devices such as readers that
  scan identification cards and bar codes permit
  only authorised staff to enter private areas.
• Budget and finance Advantages of computerised
  billing are that claims are transmitted much more
  quickly and have a greater likelihood of being
  complete and accurate compared to hand-written
  documents.
• Quality assurance Both internal and external
  stakeholders need to know that the services of a
  health care organisation have positive results.

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• Accreditation The joint Commission on
  Accreditation of Health Care Organisations
  (JCAHO) requires hospitals to have online
  mechanisms to monitor quality indicators, so as
  to reduce the difficulty and time involved in the
  accreditation process. Another aspect of
  accreditation review is demonstrating adequate
  staffing levels for the number and acuity of
  clients. Each health care facility must use a
  method of determining the number of hours of
  nursing care required for its clients.

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COMPUTERS in NURSING RESEARCH

• Computers are invaluable assistants in the
  conduct of research. In each step of the research
  process, computers facilitate generation,
  refinement, analysis, and output of data.
  Computers are, therefore, useful in the following
  aspects of the research process.
• Problem identification This is the first step in
  the research process. The computer can help in
  locating the current literature about the
  problem. Researchers may be able to locate a
  solution, unknown to them, to the problem.

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• Literature review An exhaustive review of the
  literature can be time consuming. Without
  computer access to electronic databases, the
  researcher must wade through huge volumes of
  publications.
• Research design The design of a research study,
  including the choice specific research method, is
  always driven by the research question. At the
  design stage the researcher determines whether
  the study will be qualitative or quantitative,
  data collection tools, the types of analyses that
  will be carried out on data to answer the
  research question. Computers in this stage can be
  used to search the literature for instruments
  that have already been developed.

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• Data collection and analysis Computers enable
  the creation of instruments to be used for data
  collection. This may include informed consent,
  participant information sheet, and a
  questionnaire.
• Research dissemination Research is of limited
  value if the findings are not widely disseminated
  to nurses who can use them to improve clinical
  practice. Many journals require researchers to
  submit their manuscripts for publication
  electronically, for example the Journal of
  Clinical Nursing. Computers speed completion of a
  research project and the availability of findings
  to the readers.

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• PARTIAL PARTICIPANT INFORMATION SHEET
• Title of study
• Nurses' knowledge and practice of blood
  transfusion in 2
• public hospitals, Nablus, Palestine.
• Introduction
• I am an Assistant Professor at An-Najah National
• University. This explanatory note will give
  information
• about this research project and what would be
  expected
• from you if you want to take part.
• What the study is all about
• The purpose of the study is to document current
  blood
• transfusion knowledge and practice among
  concerned
• nurses. Areas in need of improvements will be
  highlighted
• and recommendations will be made in order to
  deliver an
• effective and safe care to patients.

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• Research grants Funds are available from many
  sources for nursing research. The budget asked
  for in the grant application form may include a
  request to purchase a computer and/ or software
  needed to carry out the project.