1. Nursing Informatics

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

3. 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

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 good—standard languages
Panel assembled to help sort out the pieces

6. 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

7. 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.

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:

9. American Nurses Association
Recognized as a specialty in 1992
Defined NI, outlined roles and responsibilities and developed standards for practice.
Certification for generalist
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 field—expect change in definitions
Three categories of definitions
Technology focused
Conceptually focused
Role-Orientated
To order or for additional info on the booklet: (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 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

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 system—reports
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 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,

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 data—duplication 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),
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,

26. 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 Bethesda, MD: U.S. Department of Health and Human Services.
Turley, J.P. (1996). Toward a model for nursing informatics, Image, 28(4),