Nursing Informatics

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Nursing Informatics

• Ann Shepard, RNC, MSN
• Director, Customer Support Services
• Information Technology
• Mercy Medical Center-Des Moines

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Objectives

• Introduce Nursing Informatics
• Certification for Nursing Informatics
• Application of Nursing Informatics
• Future of NI

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How it all began.

• Late 1960s first computer systems were
  implemented in hospitals
• Computer nurses began to appear in hospitals
• Excellent clinicians
• Technically curious and willing to try new things

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or did it? The First Informatics Nurse?

• In attempting to arrive at the truth, I have
  applied everywhere for information, but scarcely
  an instance have I been able to obtain hospital
  records for any purposes of comparison. If they
  could be obtained, they would enable us to decide
  many other questions besides the one alluded to.
  They would show subscribers how their money was
  spent, what amount of good was really being done
  with it, or whether the money was not doing
  mischief rather than good.

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NI as a specialty

• Disconnected parts
• Roles, titles, and responsibilities varied
• Definitions similar, conceptual models
  considered, research in varied directions, all
  goodstandard languages
• Panel assembled to help sort out the pieces

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Definitions

• 1989Graves and Corcoran defined Nursing
  Informatics as
• Computer science, information science, and
  nursing science combined to assist in the
  management and processing of nursing data,
  information and knowledge to support the practice
  of nursing and the delivery of nursing care.
• 
  Image, p. 227

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• 1996Turley defined Nursing Informatics as the
  intersection point with Nursing Science, Computer
  Science and Information Science.
• 1995Graves et al, began to incorporate knowledge
  as a product of the sciences into the definition.

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National Center for Nursing Research

• Began in 1988
• Noted scholars met to discuss priorities for
  nursing research
• Dr. Gloria Bulechek, Dr. Judith Graves, Dr. Susan
  Grobe
• Dr. Kathryn Hannah, Dr. Norma Lang, Dr. Judy
  Ozbolt, Dr. Wm Paisley, Elliott Roberts, Dr.
  Samuel Schultz, and Rita Zielstorff
• Determined Criteria for Promising Dimensions
• Group discussed early needs for standardization
  of data sets, taxonomy to classify and allow for
  use of a common language
• Developed seven focus areas for Nursing
  Informatics
• 
  NCNR 1993
• Reference available on line http//www.nih.gov/ni
  nr/research/vol4/Overview.html

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American Nurses Association

• Recognized as a specialty in 1992
• Defined NI, outlined roles and responsibilities
  and developed standards for practice.
• Certification for generalist
• www.ana.org
• ANCC (American Nurses Credentialing Center)

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American Nurses Association

• 1994, Scope of Practice for Nursing Informatics
• 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 the expansion of nursing
  knowledge.

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ANA today

• 2001, Scope and Standards of Nursing Informatics
  Practice
• NI is an evolving fieldexpect change in
  definitions
• Three categories of definitions
• Technology focused
• Conceptually focused
• Role-Orientated
• To order or for additional info on the booklet
  www.nursebooks.org (part of the ANA web site)

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New Definition -- ANA

• Nursing Informatics is a specialty that
  integrates nursing science, computer science, and
  information science to manage and communicate
  date, information, and knowledge in nursing
  practice. Nursing informatics facilitates the
  integration of data, information, and knowledge
  to support patients, nurses, and other providers
  in their decision-making in all roles and
  settings. This support is accomplished through
  the use of information structures, information
  processes,and information technology.
• 
  ANA (2001)p. 17

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Certification

• Began in 1995
• First computer based examable to take at any
  time at any approved testing location
• Knowledge expected of a NI generalist
• Focus areas of knowledgefrom the NCNR
  recommendations for focus

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Exam Focus Areas

• System Analysis and Design
• System Implementation and Support
• System Testing and Evaluation
• Human Factors
• Computer Technology
• Information/Database Management
• Professional Practice/Trends and Issues
• Theories

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System Analysis and Design

• Conducting need and feasibility assessments
• Process flow charting
• Understanding requirements
• Quality management and customer satisfaction
  concepts

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System Implementation and Support

• Project management strategies
• Policies and procedures
• Education and training
• Communication
• Vendor management
• Customer expectations

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System Testing and Evaluation

• Will it do what we hoped it would for the costs
  we thought in the time frame we planned?
• This is our strength--assessment
• Design process
• Testing the system
• Reviewing output of the systemreports
• Measurement of pre-system goals
• Less time, more efficiently, legibility, accurate
  data, single entry, etc

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Human Factors

• Ergonomics
• Right tool for the location, the care delivered,
  the care provider
• Screen flow, use of data for decisions

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Computer Technology

• Understanding of the actual technology
• Networks
• Personal computers
• Portable devices
• Operating systems
• Software

20
Information/Database Management

• Understand database architecturehow data is
  stored and accessed
• Nursing structure
• Nomenclature/vocabulary
• Taxonomies and Coding Schemes
• ICD-P, CPT
• Nursing Minimum Data Sets
• NIC,NOC, NANDA,

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Theories

• Nursing Communication
• Management Systems
• Information
• Computer
• Behavioral
• Change theory
• Organizational behavior
• Learning

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Professional Practice/Trends and Issues

• Ethics
• Privacy
• Roles of NI
• Project Manager Researcher
• Educator Consultant
• Advocate/Policy Developer Product
  Developer
• Decision Support / Outcomes Manager

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Future of Nursing Informatics

• Emerging roles
• CIO, Entrepreneurs, Product Developers, Web
  design, Independent Consultants
• Challenges
• Integration of dataduplication often
• Inability to access data for decision making
• Unique distinctions between roles has not been
  defined--competencies

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Questions?
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References

• American Nurses Association (ANA). (1996). The
  scope of practice for nursing informatics.
  Washington, DC Author
• American Nurses Association (ANA). (2001). Scope
  and standards of nursing informatics practice.
  Washington, DC Author.
• Graves, J.R. Corcoran, S. (1989). The study of
  nursing informatics. Image, 21(4), 227-231.
• Graves, J.R., Amos. L.K., Huether, S., Lange, L.,
  and Thompson, C.B. (1995). Description of a
  graduate program in clinic nursing informatics.
  Computers in Nursing,13, 60-70.

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• National Center for Nursing Research (NCNR).
  (1993). Nursing informatics Enhancing patient
  care A report to the NCNR priority expert panel
  on nursing informatics/national center for
  nursing research. NIH Publication No. 93-2419.
  Bethesda, MD U.S. Department of Health and Human
  Services.
• Turley, J.P. (1996). Toward a model for nursing
  informatics, Image, 28(4), 309-313.