1. Changing Information of Nursing

2. HOUSE KEEPING This is 1.5 Hour class Restrooms are located…
Cell Phones
Please turn off or change to vibrate
If you must answer a call, please leave the room. 2 2

3. Learning Objectives
Identify the evolution of Nursing Informatics (NI) in health care
Identify the evolution of the Department of Veterans Administration (VA) Nursing informatics roles and articulate the role of existing strategic visions and missions of the Office of Nursing Service Informatics (ONSI) and the Chief Health Informatics Office (CHIO)
Describe the link between NI competencies and quality, safety, efficiency, and a healthy work environment
Describe the relationship of how NI can support informatics across the health care industry 3

4. Introduction 4 4

5. Introduction
Technology adoption improves safety, quality and access to care - supporting nursing informatics competencies development
Health and information technology exponential growth
Focus on quality, safety, & efficiency
Woven into the fabric of nursing practice, administration, education and research
Nursing leaders should define nursing informatics infrastructures at enterprise/system & facility/local level 5

6. What is Nursing Informatics?
Presentations, publications and surveys on the functions of the nurse Informaticist:
Nursing and Informatics for the 21st Century: An International Look at Practice, Trends and the Future - Book (2/8/2008)
Nursing Informatics 2007 Workforce Survey - Who Are We Now? - Survey Result (2/8/2008)
Nursing Informatics 2004 Workforce Survey - Who are we? - Survey Result (2/8/2008)
Nursing Informatics Presentation (2/8/2008)
An Emerging Giant: Nursing Informatics - Other Pubs (11/13/2007) 6

7. Nursing Informatics Definition
The integration of nursing science, computer and information science, and cognitive science to manage communication and expand the data, information, knowledge and wisdom of nursing practice
(ANA, 2008) 7

8. Nursing Informatics Definition (cont.)
“Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, knowledge, and wisdom 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 Scope and Standards of Nursing Informatics Practice, 2008, pg 1) 8

9. Nursing Informatics Definition (cont.)
Nursing informatics is using technology, research, and professional experience to manage nursing data, information, and knowledge to improve practice and deliver better health care.
Simpson, Roy (2006). In H. A. Park, P. Murray,& C. Delaney, C. (Eds.). Consumer-Centered Computer-Supported Care for Healthy People. Amsterdam, Netherlands: IOS Press, p 5 9

10. Domains of Nursing Informatics
System Lifecycle
Human Factors
Information Technology
Information Management
Professional Practice
Models and Theories 10

11. Nursing Informatics Competencies
Informatics Nurse Specialist skills common to Nurse Executive skills
Computer literacy skills
Information literacy skills
Project management skills
Information management and communication
Leadership
Make judgments based on data trends and patterns
Change Management
Innovation 11

12. Nursing Informatics Functional Areas
Administration, leadership and management
Analysis
Compliance & integrity management
Consultation
Coordination, facilitation, and integration
Development
Educational & professional development
Policy development & advocacy
Research evaluation 12

13. Analyst Role Quality and Safety Outcomes management
Synthesize knowledge
Performance improvement
Maintain data integrity and reliability
Aggregate data
Identify benchmarks
Develop performance measures
Assess workflow 13 13

14. Benefits of IT in Healthcare
Safety
Computer technologies can place safety barriers within high risk processes to improve patient safety 14 14

15. Benefits of IT in Healthcare (cont.)
Efficiency
Achieved through the use of computers and computer technology as a data management tool
Moving away from paper records – improves access to the data you need without flipping through a bulky patient record
Easier retrieval of data associated with a particular process
Data sharing is improved between disciplines 15 15

16. Benefits of IT in Healthcare (cont.)
Quality Improvement
Allows for auditing to assure a consistent standard of care
Measurement of performance against standards of practice to identify systems issues and opportunities for improvement 16 16

17. Benefits of IT in Healthcare (cont.)
Decision Support
Cues and information built into the system to assist the clinician in making care decisions 17 17

18. HIMSS 2007 Nursing Informatics Survey
Nursing Informatics Job Titles
14% “clinical analysts”
14% “informatics nurse specialist” or “nursing informatics specialist”
9% “consultant”
40% identified “other”
Director of Clinical Informatics, Clinical Informatics Coordinator, Clinical Systems Analyst, Clinical Informatics Specialist 18

19. What Can I Do For You? Data Management Workload statistics
Performance monitoring
Performance improvement projects
Identification of problem areas
Before and after data
Regulatory compliance 19

20. What Can I Do For You? (cont.)
Project Management
New applications
The job isn’t over when the software is implemented
Monitoring local usage
Reporting to oversight bodies
Training 20

21. What Can I Do For You? (cont.)
Training and Education
New employees
Student nurses
Updates
Annual education/competency
Ongoing reminders 21

22. What Can I Do For You? (cont.)
Be a National Voice
Software work groups
Alpha testing
Beta testing
National presentations
Oversight boards 22

23. Informatics Attitudes
Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills
Value technologies that support clinical decision- making, error prevention, and care coordination
Protect confidentiality of protected health information in electronic health records
Value nurse’s involvement in the design, selection and implementation of information systems 23 23

24. Evolution of Nursing Informatics in VA
Nursing Automated Data Processing Application Coordinator (ADPAC)
Clinical Application Coordinator (CAC)
Bar Code Medication Administration Coordinator (BCMA-C)
VA Nursing Outcomes Database Coordinator (VANOD) & Nurse Information Specialist 24

25. Evolution of Nursing Informatics in Industry25

26. Murielle Beene, Chief Nursing Informatics Officer
Creating a Nursing Informatics Infrastructure
Nursing Strategic Plan, Role of the Chief Nurse Informatics Officer
Nursing Informatics Leadership 26

27. Creating Nursing Informatics Infrastructure
Defined roles, responsibilities and resources for Nursing Informatics
Enterprise/system level
Emerging role
Chief Nursing Informatics Officer (CNIO)
Facility/local level 27 27

28. Why a Nursing Informatics Department?
Historical absence of administrative or informatics infrastructure
Disparate data sources and reports
No formal process for data validation
No formal process to assess data accuracy
Under resourced nursing management team
Missing link to the operations – important data to inform decisions making 28

29. 29

30. Typical Leadership Relationships
CEO
CMO
COO
CNO 30

31. Chief Nurse Executive Role
Critical in selection, implementation, and evaluation
Overall facility/healthcare system impact
Nurse Executive must be actively involved in over-all decision-making and implementation process 31 31

32. VHA Nursing Strategic Plan 2008-2012
Office of Nursing Service Vision includes… “Communicating nursing data using IT as an information management tool to manage easy access to forecast, access & communicate data.”
National Nursing goals:
Nursing Practice Transformation
Evidence-Based Practice
Excellence in Leadership
Workforce Management
Interconnected & Interdependent Critical Programs:
Informatics & Technology
Data Management
Research
Advanced Practice 32

33. Proposed Informatics Relationships
CIO
CMIO
CNIO 33

34. Emerging Chief Nurse Informatics Officer Role
Set strategic vision for nursing informatics to support a collaborative practice that reaches across and between service lines
Develop a vision, mission, and strategic plan for nursing informatics
Leverage technology to create synergy in practice that will improve patient care delivery, efficiency, quality, and safety 34

35. Chief Nurse Informatics Officer Focus Area
Strategic vision for informatics and impact on nursing practice and care delivery
Human factors and ergonomics
Technology assessment
Data and databases
Communication
Resource planning and utilization
Research, development and evaluation 35

36. Proposed Enterprise Infrastructure36

37. Proposed Local Infrastructure37 37

38. On Leadership…
“Innovation distinguishes between a leader and a follower.”
Steve Jobs
“A leader has the vision and conviction that a dream can be achieved. He inspires the power and energy to get it done”
Ralph Nader 38

39. NI Leadership Skills Superb communication Change management
Risk Assessment
Coalition building
Political finesse
Business acumen
Strategic application
(ANA, 2008) 39

40. NI Leadership Role Evidence-based practice Computer literacy skills
Information literacy skills
Project management skills
Change management skills
Process management skills
Information management and communication
Data analysis
Trending & forecasting
Resource planning, utilization and evaluation
Technology assessment
Administration
Safety and quality
Make judgments based on data trends and patterns
Consultant
Innovator 40

41. Leadership Pearls DREAM, DARE, AIM to be an INNOVATOR
Keep abreast of “latest greatest” technology trends
Assess newest technology for “fit” and potential applicability in the clinical environment
Leverage technology to improve quality, safety and nursing outcomes as you continue the ongoing journey toward innovation and clinical excellence 41

42. Questions? 42

43. THANK YOU!