1. Collective Action Nursing Informatics

2. Collective Action O Activities that are undertaken by a group of people who have common interests. O Aids nurses in advocating for patients, families, and communities in healthcare and political arenas

3. Four Main Purposes of Collective Action for Nurses O To promote the practice of professional nursing O To establish and maintain standards of care O To allocate resources effectively and efficiently O To create satisfaction ad support in the practice environment

4. Nursing Governance O The method or system by which a department of nursing controls and directs the formulation and administration of nursing policy.

5. The Focus O Nurses have three strategies to achieve collective action: O Shared governance O Workplace advocacy O Collective bargaining

6. Shared Governance O A democratic, egalitarian concept O A dynamic process O A process of shared decision making and accountability

7. Shared Governance Can: O Lead to better decisions. O Be more effective in day-to- day practices. O Generate additional ideas for implementation.

8. Workplace Advocacy O The objective is to equip nurses to practice in a rapidly changing environment. Advocacy occurs within a framework of mutuality, facilitation, protection, and coordination.

9. Manifestations of Workplace Advocacy O Ensuring relevant information O Enabling the selection of information O Disclosing a personal view O Providing support for making and implementing decisions O Helping determine personal values

10. Collective Bargaining “ … the performance of mutual obligation of the employer and the representatives of the employees to meet at reasonable times and confer in good faith with respect to wages, hours, and other terms and conditions of employment or the negotiation of any agreement or any question arising thereunder... ” Labor Management Reporting Act, 1947, Section 8

11. Collective Bargaining cont.- O Nurses have a low rate of unionization. O Nurses are a prime target for membership growth. O Constant challenges exist to the way nurses are viewed for collective bargaining purposes.

12. Nurses as Knowledge Workers O Nurses have multiple degrees and certifications O Practice is guided by science rather than procedure O Collective action is geared towards improving patient outcomes/quality of care

13. Union or At Will O At will employees can be terminated for any reason except discrimination within reason of the law O Employees are at the “will” of the employer O Unions require employers to follow due process. Unionized employees have more “rights” and are represented by the union

14. Whistleblower Protection O Whistleblowing “ refers to a warning issued by a current or former employee of an organization to the public about a serious wrongdoing or danger created or concealed within the organization ” (Hunt, 1995, p. 155). O The 1989 Whistle Blower Protection Act protects federal workers. The law does not cover the private sector.

15. Selecting a Bargaining Agent O A strong commitment to nursing practice, legislation, regulation, and education O A well-prepared practice, policy, and labor staff; a minimum of a bachelor ’ s degree in nursing O Representative of those the bargaining unit represents in both gender and ethnic makeup O National scope and local implementation O Control by individual members over bargaining unit activities

16. Selecting a Bargaining Agent O ANA created the UAN in 1999 to ensure that nurses have access to collective bargaining O Today it has joined with other nursing organizations to form the National Nurses United O Not all nurses are eligible to join a union; nurses who are statutory supervisors are not eligible.

17. Caring, Communicating, and Managing with Technology Chapter 11

18. Nurses and Technology O Nurses are knowledge workers; they need data and information to do their jobs effectively O Nurse knowledge workers need support from information technologies

19. Types of Technology O Biomedical O Informational O Knowledge

20. Biomedical Technology O Four types of technologies: O Physiologic monitoring – EKG, ICP monitoring O Diagnostic testing – Can also be EKG, ICP monitoring O Drug administration – Automated Dispensing Cabinets (Pyxis) O Therapeutic treatments – insulin pumps

21. Information Technology O Computers: O Store. O Organize. O Retrieve. O Communicate.

22. Structured Terminologies O Collecting information from every patient and every health care encounter can be used to make comparisons among patients, organizations, and countries O The Nursing Minimum Data Set (NMDS) was created to define essential data elements to be collected on all patients

23. Four Purposes of NMDS O Establish the comparability of patient care across clinical populations, settings, geographical areas and time O Describe the care of patients and families in various settings O Provide a means to mark the trends in the care provided and the allocation of nursing resources based on health problems or nursing diagnosis O Stimulate nursing research through links to existing data O Provide data about nursing care to influence and facilitate health care policy decision making

24. Information Systems O Issues: O Patient safety O Ethics O Information security O Privacy

25. Nursing Informatics O Informatics is “A science that combines a domain science, computer science, information science, and cognitive science” (Hunter, 2001, p. 180) O Nursing Informatics is “ the application of computer technology to all fields of nursing – nursing services, nurse education, and nursing research” O Nursing informatics is the transformation of data into information then knowledge

26. Knowledge Technology O Systems that generate or process knowledge and provide clinical decision support O Clinical decision support systems are a clinical computer system, application or process that helps health professionals make clinical decisions to enhance patient care; they mimic the inductive and deductive reasoning a human expert

27. Evidenced-Based Practice (EBP) O Whether you are a leader, a manager, or a follower, you have to rely on evidence-based practices to enact your profession. O A systematic approach to clinical decision making to provide the most consistent and best possible care to patients

28. Five Key Elements of EBP O Ask a clinical question. O Acquire the evidence. O Appraise the evidence. O Apply the evidence. O Assess the outcomes.

29. Ask a Clinical Question O PICO O Population O Intervention O Comparison O Outcome PICO determines the nature of the question.

30. Acquire the Evidence O Only through computerized technologies can we search the literature in an efficient manner.

31. Appraise the Evidence O Answer these questions about the evidence found: O Is it valid? O Is it important? O Is it important to the patient?

32. Apply the Evidence O Depending on your organization, you need to apply the new evidence or propose a practice change to the appropriate body.

33. Assess the Outcomes O Informatics plays an important role in the measurement of daily practices and the synthesizing of data into reports.

34. Technology and Health Care: Smart Cards O Patient demographics/photo identification O ICE—In Case of Emergency—contact and other key information O Patient medical history: allergies, medications, immunizations, laboratory results, etc. O Past care encounter summaries, including surgical procedures O Patient record locations and electronic address information O Ability to upload or download patient information

35. 10 C’s for Evaluating Internet Sources O Content O Credibility O Critical thinking O Copyright O Citation O Continuity O Censorship O Connectivity O Comparability O Context

36. Reference O Yoder-Wise, P.S. (2011). Leading and Managing in Nursing (5 th ed). St. Louis, MO: Elsevier-Mosby, Inc.