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Nursing Informatics

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Title: Nursing Informatics


1
Nursing Informatics
  • Ann Shepard, RNC, MSN
  • Director, Customer Support Services
  • Information Technology
  • Mercy Medical Center-Des Moines

2
Objectives
  • Introduce Nursing Informatics
  • Certification for Nursing Informatics
  • Application of Nursing Informatics
  • Future of NI

3
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

4
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.

5
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

6
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

7
  • 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.

8
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

9
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)

10
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.

11
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)

12
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

13
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

14
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

15
System Analysis and Design
  • Conducting need and feasibility assessments
  • Process flow charting
  • Understanding requirements
  • Quality management and customer satisfaction
    concepts

16
System Implementation and Support
  • Project management strategies
  • Policies and procedures
  • Education and training
  • Communication
  • Vendor management
  • Customer expectations

17
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

18
Human Factors
  • Ergonomics
  • Right tool for the location, the care delivered,
    the care provider
  • Screen flow, use of data for decisions

19
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,

21
Theories
  • Nursing Communication
  • Management Systems
  • Information
  • Computer
  • Behavioral
  • Change theory
  • Organizational behavior
  • Learning

22
Professional Practice/Trends and Issues
  • Ethics
  • Privacy
  • Roles of NI
  • Project Manager Researcher
  • Educator Consultant
  • Advocate/Policy Developer Product
    Developer
  • Decision Support / Outcomes Manager

23
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

24
Questions?
25
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.

26
  • 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.
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