Practice Application

FRANCIS OBMERGA, RN, MAN1Practice Application4/24/2012 11:35 AMHistorical PerspectiveMore than 150 years ago, Florence Nightingale spoke about the critical importance of nursing informatics in patient care. "Decision making must be based upon the use of accurate data," 2FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM

Historical PerspectiveThe first hospital information systems arrived in late 1950s to the mid-1960s, although these systems focused primarily on processing financial and administrative information. 3FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM

Historical PerspectiveIn 1965, the American Hospital Association conferences for hospital administrators signalled the emerging move toward more clinical adaptations of such systems in healthcare4FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM

Historical PerspectiveIn the 1970s, the advent of the silicon chip allowed the focus to shift from one large supercomputer to smaller personal computers that could be adapted for many different applications throughout the hospital system.

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Historical PerspectiveBy the 1980s, the computer was being used for diverse hospital functions such as radiology, pharmacy, and laboratories. At this time, there emerged "a strong drive within healthcare to understand how clinicians would use the new tools to advance practice"

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Historical PerspectiveThroughout the 1990s, expanded uses of computers evolved as nurses used it to improve patient care and conduct research by analyzing patient trends, variability in practice; and outcomes of care. 9FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM

Historical PerspectiveAlong with the most recent standards of nursing informatics practice which were set forth by the American Nurses Association (ANA) in 2001, extent of practice applications which involve computers, controversies surrounding nomenclature, the use of decision support systems, and nursing perspectives on the perceived value-added of using information systems in patient care. 10FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM

Nursing Informatics: An Evolving Definition1980Nurses interacting with technology to produce greater knowledge, or on the role of nurses who specialized in developing applications of technology to nursing practice. 11FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMNursing Informatics: An Evolving Definition1989"combination of nursing science, information science, and computer science to manage and process nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing careGraves and Corcoran12FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMNursing Informatics: An Evolving Definition1992 A 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, and research; and to expand nursing knowledge. The purpose of nursing informatics is to analyze information requirements; design, implement and evaluate information systems and data structures that support nursing, and identify and apply computer technologies to nursing. 13EDWIN O. BRACAMONTE, RN, MANNursing Informatics: An Evolving Definition1994Nursing informatics supports the practice of nursing specialties in all sites and settings whether at the basic or advanced levels. The practice includes the development of applications, tools, processes and structures that assist nurses with management of data in taking care of patients or in supporting their practice of nursing.14FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMNursing Informatics: An Evolving Definition2001Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, 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.15FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMNursing Informatics: An Evolving DefinitionThe goal of nursing informatics, is to:Improve the health of populations, communities, families, and individuals by optimizing information management and communication. This includes using technology in the direct provision of care; establishing administrative systems; managing and delivering educational experiences; supporting life-long learning, and supporting nursing research.

16FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMStandards for PracticeInformatics Competencies: Beginning to ExperiencedComputer literacy skills: These are the basic computer skills needed to use a word processor; access a database; create a spreadsheet; communicate with e-mail; and interact with clinical documentation systems.

17FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMStandards for PracticeInformatics Competencies: Beginning to ExperiencedInformation literacy skills: These include the ability to recognize the need for information and the skill to access, evaluate and interpret information correctly.

18FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMStandards for PracticeInformatics Competencies: Beginning to ExperiencedGeneral informatics competencies: These basic skills are required for all nurses but are not sufficient for specialists: identifying, collecting and recording data relevant to the nursing care of patients; analyzing and interpreting patient and nursing information; using applications of informatics as an integral part of the nursing process; and implementing institutional and public policies regarding privacy, confidentiality and security of information.

19FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AMProblem Solving as an Organizing FrameworkAccording to the ANA (2001), the informatics nurse specialist moves beyond the foundational competencies and into a practice specialty in which there are organized and recognized standards of practice and performance standards. These standards include six major areas that mirror the traditional nursing process. 20FRANCIS OBMERGA, RN, MAN4/24/2012 11:35 AM4/24/2012 11:35 AMFRANCIS OBMERGA, RN, MAN21Nursing Informatics Standards Of Practice:The Problem SolvingFrameworks

AssessmentDiagnosisIdentification of OutcomesPlanningImplementationEvaluationNursing informatics standards of practice: the problem solving frameworkRecognized Terminologies that Support Nursing Practice: The following 13 languages have been recognized by the American Nurses Association (ANA) as those classification systems that have been uniquely developed to document the entire process of clinical care for patientsNANDAnursing diagnosis, definition, and classificationNICNursing Interventions definitions, and classificationsHHCCHome HealthOMAHA systemNOCNursing Outcomes ClassificationNMMDSnursing management minimum data setPCDSpatient care data setPNDSperi-operative data setSNOMED CTNMDSnursing minimum data setABC codesICNPInternational Classification for Nursing PracticeLOINC Logic Observation Identifiers Names And Codes

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