Practice Applications

Johanna M. Nazareno, R.N.

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Which famous theorist said, “ Decision making must be based upon the use of

accurate data?

Florence Nightingale

Virginia Henderson

Imogene King

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History of Informatics in Healthcare and in Nursing

• Late 1950s to mid 1960s- First Hospital Information System

• 1965 – American Hospital Association

• 1970s- birth of the Silicon Chip

• 1980s- used in diverse hospital functions

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“The contemporary system of healthcare is a new

terrain that is no longer confined to hallowed halls of

brick and mortar institutions. Instead, it has become a

point and click system with leveled boundaries that

promotes unfettered public access to healthcare

information and untraditional communication between

providers and patients.”

- Barbara Carty

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“Healthcare has now shifted its

focus from bringing individuals new

technology to making the available

technology work for clinicians.”

-Nelita (Marianela) Zytkowski Senior Director of Nursing Informatics

Cleveland Clinic of Ohio

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Standards of Nursing Informatics have been established by ANSAP in the year

2000. True

False

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• In 1980, American Nurses Association has defined Nursing Informatics broadly on two concepts:

1. nurses interacting with technology to produce greater knowledge

2. nurses specializing in the development of applications of technology to nursing practice

Evolution of Nursing Informatics

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• 1989- defined with the combination of three core sciences: nursing science, information science and computer science • 1992- ANA’s Council on Computer Application in Nursing incorporated into its definition the expanding role of the informatics nurse specialist • 1994- ANA again revised its definition by replacing specifics about the systems life cycle with a more general description ** These definitions do not acknowledge and incorporate the “nursing phenomena.”

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“Nursing Phenomena” includes:

Nurse, patient and treatment

Nurse, patient and health

Nurse, patient, health and environment

Nurse, patient, health and treatment *CNISNAZARENO12S*

other critical elements: • Data

• Information

• Knowledge

• Nursing Science

• Decision Making

• Information Technology

• Information Structures

• Information Management and Communication

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• In 2001, ANA Scope and Standards of Nursing Informatics offered the newest definition:

Nursing 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.

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Essential Elements of Nursing Informatics

Patient Health

Nurse

Tools from information science and computer

science Information technology, structures management

and communication

Environment

Scientific Foundations

Nursing, Computer and Information

Science

Metastructures Data, Information

and Kowledge

American Nurses Association (2001) Scopes and Standards of Practice for Nursing Informatics *CNISNAZARENO12S*

According to ANA, the goal of NI is to improve the health of populations, communities, families and

individuals by optimizing information mgt and communication.

True

False

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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.

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Informatics Competencies Three Major Domains:

1. Computer Literacy Skills

- word processor, spreadsheet, email, etc.

2. Information Literacy Skills

- ability to recognize the need for information

- skill to access, evaluate and interpret info correctly

3. General Informatics Competencies

- required for all nurses

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Evaluation

Implementation

Planning

Identification of Outcomes

Diagnosis

Assessment

Nursing Informatics

Standards of Practice:

The Problem Solving

Framework

Problem Solving Framework of ANA 2001

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TYPES OF INFORMATION

SYSTEMS

1. Admission, Discharge and Transfer

2. Financial Systems

3. Order Entry

4. Ancillary Systems

5. Clinical Documentation *CNISNAZARENO12S*

6. Scheduling

7. Acuity

8. Specialty Systems

9. Communication Systems

10. Critical Pathways

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Applications of Nursing Informatics Nursing Practice

• work lists

• computer –generated client documentation

• monitoring devices

• automatic billing

• reminders and prompts that ensure comprehensive charting

• quick access to patient data

• online drug information

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Nursing Administration

• automated staff scheduling

• online bidding for unfilled shifts

• electronic mail

• cost analysis and finding trends

for budget purposes

• quality assurance and outcome

analysis

• patient tracking and placement

for case mgt

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Nursing Education

• online course registration and scheduling • computerized student tracking and grade mgt • computer-assisted instruction • course delivery and support for Web-based education • remote access to library and internet resources • teleconferencing and webcast capability • presentation software • online tests • communication with students

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Nursing Research

• computerized literature searching

• adoption of standardized language related to nursing terms

• ability to find trends from data derived from large populations

• use of internet for data collection

• collaboration with other nurse researchers is possible

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Nurses are key contributors to patient care and healthcare policy, and must proactively engage in all phases of information systems development (Johnson,2006).

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“If technology is the “tool of commonality,”

then the nursing profession must use that tool

to its fullest to advance patient care and

nursing practice.”

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Practice Applications

Johanna M. Nazareno, R.N.

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