Nursing in for Matics Past Present Future

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Nursing InformaticsAnn Shepard, RNC, MSN Director, Customer Support Services Information Technology Mercy Medical Center-Des Moines

ObjectivesIntroduce Nursing

Informatics Certification for Nursing Informatics Application of Nursing Informatics Future of NI

How it all began.Late 1960s

first computer systems were implemented in hospitals Computer nurses began to appear in hospitalsExcellent

clinicians Technically curious and willing to try new things

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 specialtyDisconnected partsRoles, titles, and

responsibilities varied Definitions similar, conceptual models considered, research in varied directions, all goodstandard languages Panel assembled to help sort out the pieces

Definitions1989Graves and

Corcoran defined Nursing

Informatics asComputer

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

1996Turley defined Nursing

Informatics as the intersection point with Nursing Science, Computer Science and Information Science. 1995Graves et al, began to incorporate knowledge as a product of the sciences into the definition.

National Center for Nursing Research Began

in 1988scholars met to discuss priorities for nursing research

Noted 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:

American Nurses AssociationRecognized as a

specialty in 1992 Defined NI, outlined roles and responsibilities and developed standards for practice. Certification for generalist ANCC (American Nurses Credentialing Center)

American Nurses Association1994, ScopeNursing

of Practice for Nursing Informatics

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 today2001, ScopeNI

and Standards of Nursing Informatics Practiceis an evolving fieldexpect change in definitions Three categories of definitions Technology

focused Conceptually focused Role-OrientatedTo order or for additional info on the booklet: (part of the ANA web site)

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


in 1995 First computer based examable to take at any time at any approved testing location Knowledge expected of a NI generalist Focus areas of knowledgefrom the NCNR recommendations for focus

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

System Analysis and DesignConducting need

and feasibility assessments Process flow charting Understanding requirements Quality management and customer satisfaction concepts

System Implementation and SupportProject management strategiesPolicies and

procedures Education and training CommunicationVendor

management Customer expectations

System Testing and EvaluationWill

it do what we hoped it would for the costs we thought in the time frame we planned? This is our strength--assessmentDesign

process Testing the system Reviewing output of the systemreports Measurement of pre-system goals Less

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

Human FactorsErgonomicsRight

tool for the location, the care delivered, the care provider Screen flow, use of data for decisions

Computer TechnologyUnderstanding ofNetworks Personal

the actual technology

computers Portable devices Operating systems Software

Information/Database ManagementUnderstand database architecturehow data


stored and accessed Nursing structureNomenclature/vocabulary Taxonomies ICD-P,

and Coding Schemes



Minimum Data Sets



ManagementInformation Computer BehavioralChange

Communication Systems

theory Organizational behavior Learning

Professional Practice/Trends and IssuesEthics Privacy Roles

of NI


Manager Researcher Educator Consultant Advocate/Policy Developer Product Developer Decision Support / Outcomes Manager

Future of Nursing InformaticsEmergingCIO,


Entrepreneurs, Product Developers, Web design, Independent Consultants


of dataduplication often Inability to access data for decision making Unique distinctions between roles has not been defined--competencies


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), 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.


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.