THEORIES, MODELS, AND FRAMEWORKS

OBJECTIVES 1. Discuss the relationship between healthcare informatics and nursing informatics. 2. Discuss different definitions and models of nursing and healthcare informatics. 3. Discuss core concepts and the scope of practice of nursing informatics. 4. Describe nursing informatics as a distinct specialty. 5. Discuss key aspects of the Electronic Health Record (EHR). 6. Discuss terminologies for nursing. 7. Identify available organizational resources.

KEY WORDS Informatics Electronic Health Record Competencies Terminologies

Abstract Nursing informatics is an established and growing area of specialization in nursing. All nurses employ information technologies in their practice.

Introduction Lifelong learning is based on the recognition of patterns and variances, builds on previous experiences and knowledge, and involves the use of analogies. Theories, Models, Frameworks, clearly stated definitions and foundational documents can guide the nursing informatics learning activities for both student and faculty.

“Nursing practice will be revolutionized and we will truly be a profession of nurses with our own classification systems, bibliographic systems, and payment systems.”

We need to use the Internet to enhance our practice and to provide a tele-nursing care. We need to become wireless and conduct our services using all the newer IT tools. “ We have along way to go, but if we utilize information technology effectively, informatics will become an integral part of our profession and the health care industry. I do believe we have the knowledge and perseverance and I am convinced it will come to pass.”– Dr. Virginia Saba

Informatics and Healthcare Informatics

What is Informatics?

1957 – First coined by Karl Steinbuch as “Informatiks”. 1962 – Phillipe Dreyfus used “Informatique”. Walter Bauer – translated it to “Informatics”

Combined the term “information” and “automation” which means automatic information processing.

A science that combines a domain science, computer science, information science, and cognitive science. Multidisciplinary science drawing from varied theories and knowledge applications. A broad academic field encompassing human-computer interaction, information science, information technology, algorithms, and social science.

Computer Science, the study of complex system, information and computation using applied mathematics, electrical engineering and software engineering techniques. Information Science, is the study of processing, management and retrieval information.

In 1980, Sholes and Barber applied this new term to the art of science and nursing, coining the term, “Nursing Informatics”, which they defined as “…the application of computer technology to all fields of nursing---nursing services, nurse education and nursing research”.

What is Healthcare Informatics?

Integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information. A subdiscipline of informatics.

Activity Present an illustration using the description delineating Health Informatics and its sub discipline. Health Informatics have subdomains such as medical informatics, dental informatics, pharmacy informatics, nursing informatics, etc. Each of this subdomains have integrated content and which are collaboratively working with each other.

Limit your illustration using only circles, squares and arrows and texts. Use any application (paint, Msword, Ppt) in making your diagram. Finally present the illustration using the powerpoint. Further explain your diagram.

1985 - Kathryn Hannah… Is the use of information technologies in relation to the nursing functions. 1989 – Graves & Corcoran… Is a combination of computer science, information science and nursing science designed to assist management and processing nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care. 1994 – ANA… 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. 2001 – ANA… A specialty that integrates nursing science, computer science and information science to manage and communicate data, information and knowledge of nursing practice. 2001- ANA… Facilitates the integration of data, information, and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. The support is accomplish through the use of information structures, information processes , and information technology.

SCOPE OF PRACTICE PRACTICE EDUCATION RESEARCH ADMINISTARTION

COPUTER BASE CLIENT RECORD BEDSIDE DATA ENTRY Records client assessments, medication administration, progress notes, care plan updating, client acuity, and accrued charges. COPUTER BASE CLIENT RECORD EMRs/PRCs Provides easy retrieval of specific data such as trends in vital signs, immunization records and current problems. It can be designed to work providers about conflicting medications or client parameters that indicate dangerous conditions.

ELECTRONIC ACCESS TO CLIENTS Use extensively to health care to assess and monitor clients condition. Data accumulated to various electronic devices are stored to research purposes. Can monitor client Computerized diagnosis Telemedicine PRACTICE MANAGEMENT Used to supplies, tests, meals, and services from other departments. Allows nursing service to determine the most costly items used by a particular nursing unit. May provide information or decisions to modify budget, provide different staffing, move supplies to different locations, or make other changes for more efficient and higher quality care.

NURSING INFORMATICS AS SPECIALTY

1992 – ANA established nursing informatics as a distinct specialty in nursing with a distinct body of knowledge.

INDIVIDUAL ACTIVITY USED A WORD PROCESSOR Explain how nursing informatics is considered as a distinct specialty. Specifically described the roles of informatics nurses compared to the other fields of nursing. 200 words minimum.

USED A WORD PROCESSOR Used Times New Roman Front size: 12.5 Line spacing: 1.5 1 tab indent each paragraph Justify each paragraph Margins: 0.75” top 0.75”bottom,1”left,1”right Orientation: Portrait Paper size: Long bond paper Title at center (make your own) Save Files: Act1YourName.doc

INFORMATICS NURSES AS SPECIALIST Is a professional with a formal RN graduate degree and passed the credentialing in nursing informatics in a state. Nursing Informatics specialists practice in a wide variety of roles that are ultimately aimed at improving patient care delivery and the nursing practice experience.

Some of these roles are: Project manager Educator Product developer Decisions support/outcome manager System analysis Consultant Programmer Advocate/Policy Developer Web developer CIO, CEO, CNO Entrepreneur Researcher Sales and marketing

Components of Practice TRANSFORMATION OF DATA TO WISDOM DATA – discrete entities that are described objectively without interpretation. ex: A systolic blood pressure, a nursing intervention, a patient problem, an outcome. INFORMATION - reflects interpretation, organization, or structuring of data. Are process data Data with meaning KNOWLEDGE – transformation of information. Information that is synthesized so that relationship are identified and formalized.

As an example, a single instance of vital signs: heart rate, respiration, temperature and blood pressure- for single patient to be considered a set of data. A series of vital signs taken over time, placed into a context, and compared is considered. However a dropping blood pressure, increasing heart rate, respiratory rate, and fever in an elderly, catheterized patient are recognized as being out of the norm. The recognition that this patient may be septic and in need of nursing and medical intervention reflects information synthesis (knowledge).