Nursing Informatics

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

How it all began…. Late 1960’s first computer systems were implemented in hospitals Computer nurses began to appear in hospitals Excellent clinicians Technically curious and willing to try new things

…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.”

NI as a specialty Disconnected parts Roles, titles, and responsibilities varied Definitions similar, conceptual models considered, research in varied directions, all good—standard languages Panel assembled to help sort out the pieces

Definitions 1989—Graves 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

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

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/ninr/research/vol4/Overview.html

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)

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”.

ANA today 2001, Scope and Standards of Nursing Informatics Practice NI is an evolving field—expect 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)

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

Certification Began in 1995 First computer based exam—able to take at any time at any approved testing location Knowledge expected of a NI generalist Focus areas of knowledge—from the NCNR recommendations for focus

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

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

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

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 system—reports Measurement of pre-system goals Less time, more efficiently, legibility, accurate data, single entry, etc

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

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

Information/Database Management Understand database architecture—how data is stored and accessed Nursing structure Nomenclature/vocabulary Taxonomies and Coding Schemes ICD-P, CPT Nursing Minimum Data Sets NIC,NOC, NANDA,

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

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

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

Questions?

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.

National Center for Nursing Research (NCNR). (1993) 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.