Nursing Informatics

Ann Shepard, RNC, MSNDirector, Customer Support Services

Information TechnologyMercy Medical Center-Des Moines

ObjectivesObjectives

Introduce Nursing InformaticsCertification for Nursing InformaticsApplication of Nursing InformaticsFuture of NI

How it all began….How it all began….

Late 1960’s first computer systems were implemented in hospitals

Computer nurses began to appear in hospitalsExcellent cliniciansTechnically curious and willing to try new things

…or did it? The First Informatics

Nurse?

…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 specialtyNI as a specialty

Disconnected partsRoles, titles, and responsibilities variedDefinitions similar, conceptual models

considered, research in varied directions, all good—standard languages

Panel assembled to help sort out the pieces

DefinitionsDefinitions

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 National Center for Nursing Research

Began in 1988Noted scholars met to discuss priorities for nursing research

Dr. Gloria Bulechek, Dr. Judith Graves, Dr. Susan GrobeDr. Kathryn Hannah, Dr. Norma Lang, Dr. Judy Ozbolt, Dr. Wm

Paisley, Elliott Roberts, Dr. Samuel Schultz, and Rita ZielstorffDetermined ‘Criteria for Promising Dimensions’Group discussed early needs for standardization of data sets,

taxonomy to classify and allow for use of a common languageDeveloped seven focus areas for Nursing Informatics

» NCNR 1993 » Reference available on line:

http://www.nih.gov/ninr/research/vol4/Overview.html

American Nurses Association

American Nurses Association

Recognized as a specialty in 1992Defined NI, outlined roles and responsibilities

and developed standards for practice.Certification for generalist

www.ana.org ANCC (American Nurses Credentialing Center)

American Nurses Association

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 todayANA today

2001, Scope and Standards of Nursing Informatics Practice

NI is an evolving field—expect change in definitionsThree categories of definitions

Technology focusedConceptually focusedRole-Orientated

To order or for additional info on the booklet: www.nursebooks.org (part of the ANA web site)

New Definition -- ANANew 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

CertificationCertification

Began in 1995First computer based exam—able to take at any

time at any approved testing locationKnowledge expected of a NI generalistFocus areas of knowledge—from the NCNR

recommendations for focus

Exam Focus AreasExam Focus Areas

System Analysis and DesignSystem Implementation and SupportSystem Testing and EvaluationHuman FactorsComputer TechnologyInformation/Database ManagementProfessional Practice/Trends and IssuesTheories

System Analysis and Design

System Analysis and Design

Conducting need and feasibility assessmentsProcess flow chartingUnderstanding requirementsQuality management and customer satisfaction

concepts

System Implementation and Support

System Implementation and Support

Project management strategiesPolicies and proceduresEducation and trainingCommunication

Vendor managementCustomer expectations

System Testing and Evaluation

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--assessmentDesign processTesting the systemReviewing output of the system—reportsMeasurement of pre-system goals

Less time, more efficiently, legibility, accurate data, single entry, etc

Human FactorsHuman Factors

ErgonomicsRight tool for the location, the care delivered, the

care providerScreen flow, use of data for decisions

Computer TechnologyComputer Technology

Understanding of the actual technologyNetworksPersonal computersPortable devicesOperating systemsSoftware

Information/Database Management

Information/Database Management

Understand database architecture—how data is stored and accessed

Nursing structureNomenclature/vocabularyTaxonomies and Coding Schemes

ICD-P, CPTNursing Minimum Data Sets

NIC,NOC, NANDA,

TheoriesTheoriesNursing CommunicationManagement SystemsInformationComputerBehavioral

Change theoryOrganizational behaviorLearning

Professional Practice/Trends and Issues

Professional Practice/Trends and IssuesEthicsPrivacyRoles of NI

Project Manager ResearcherEducator Consultant Advocate/Policy Developer Product DeveloperDecision Support / Outcomes Manager

Future of Nursing Informatics

Future of Nursing Informatics

Emerging rolesCIO, Entrepreneurs, Product Developers, Web

design, Independent ConsultantsChallenges

Integration of data—duplication oftenInability to access data for decision makingUnique distinctions between roles has not been

defined--competencies

Questions?Questions?

ReferencesReferencesAmerican Nurses Association (ANA). (1996). The scope of

practice for nursing informatics. Washington, DC: AuthorAmerican 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). 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.