NURSING INFORMATICS

Nursing Informatics (ANA,2001) - a specialty that integrates Nursing science, Computer science, and Information science to manage and communicate data, information and knowledge in nursing practice.

Nursing Science

Information Science

Computer Science

Nursing Informatics (ANA,2001) - it facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings.

Nursing Informatics (ANA,2001) - the support is accomplished through the use of information structures, information processes, and information technology.

Nursing Informatics (my.clevelandclinic.org, 2011) -Nursing Informatics participates in multidisciplinary strategic planning to determine system solutions that support patient care, set standards for clinical applications, conform to accreditation standards and regulatory requirements and transform clinical practice.

Nursing Informatics and Nursing Process (http://www.childrenscentralcal.org, 2011) The nursing process is the core of patient care delivery. In the nursing process continuum, nurses are constantly faced with data and information. Data and information are integrated in each step of the nursing process: 1) assessment, 2) diagnosis, 3) planning, 4) implementation, and 5) evaluation. Nursing documentation, which is often identified as the sixth step in the nursing process, is vital in information management. Therefore, it is necessary for nurses to document accurately and precisely to determine the desired outcome.

Electronic Health Record (EHR)

(also Electronic Patient Record or Computerized Patient Record) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations.

 It is a record in digital format that is capable of being shared across different health care settings, by being embedded in network-connected enterprise-wide information systems.

 Such records may include a whole range of data in comprehensive or summary form, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, and billing information.

Why? Need for accurate and efficient flow of patient medical and billing information. Data needs gate-keeping physicians, demands by payers for performance report cards. Growth of shared care patient shares responsibility with the provider for care.

What are the concerns for EHR implementation? - Privacy and confidentiality - Looking into system errors - Evaluating the value of IT investment.

Nursing standards - a measure or measures by which nursing

care can be judged or compared; the measures used are agreed upon by common consent. Standards for an agreed level of care for a particular purpose should be derived and set in a democratic way, with the participation of all those involved.

Telehealth
- is the delivery of health-related services and information via telecommunications technologies. - Telehealth delivery could be as simple as two health professionals discussing a case over the telephone, or as sophisticated as using videoconferencing between providers at facilities in two countries, or even as complex as robotic technology.

 Telehealth is an expansion of telemedicine, and unlike telemedicine (which more narrowly focuses on the curative aspect) it encompasses preventive, promotive and curative aspects. Originally used to describe administrative or educational functions related to telemedicine, today telehealth stresses a myriad of technology solutions. For example, physicians use e-mail to communicate with patients, order drug prescriptions and provide other health services.

Clinical Information System (CIS)

A hospital information system (HIS), variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital . This encompasses paper-based information processing as well as data processing machines.

It can be composed of one or a few software components with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties (e.g. Laboratory Information System, Radiology Information System). CISs are sometimes separated from HISs in that the former concentrate on patient-related and clinical-staterelated data (electronic patient record ) whereas the latter keeps track of administrative issues. The distinction is not always clear and there is contradictory evidence against a consistent use of both terms.

Computer Information Officer (CIO) The Chief Information Officer (CIO) is the head of the IT group within an organization, and usually reports to the Chief Executive Officer (CEO). They provide organizations with the vision to master information technology as a competitive tool.

 A CIO may
be a member of the organizations executive team and be involved in the strategic business planning oversee the work of the entire IT team, section or department, and provide support and mentoring to IT management personnel

 be responsible for the overall strategic direction and management of the organizations IT infrastructure ensure the IT strategy meets the growth and business strategy of the organization

Nursing Informatics and Clinical Information Systems What is the Impact of nursing information technology systems to nursing and patient care? In the year 2010 majority of nurses entering the profession are COMPUTER LITERATE. Every health care setting will employ at least 1 NI specialist to implement CIS

Nursing Informatics and Clinical Information Systems CIS is designed to support nursing practice; It requires understanding of professional nursing practice and technology that applies science to function electronically; Nurses demand CIS to document care; The increase in EHR prompted interest in NI

NEW TECHNOLOGY

CPOE Computerized patient order entry CCC Clinical Care classification Telehealth

NURSING INFORMATICS HISTORY

 Six Time Period

Before the 60s computers in business functions; e.g punch cards, teletypewriters; 1960s Why computers?; what should be computerized?; HIS; financial transactions 1970s recognized the value of computers in nursing; large community health agencies used computerized management information systems (MIS)

 1980s fields of informatics emerged; computer based patient records; discharge planning systems; PC were user-friendly and allowed nurses to create their own applications 1990s computers became integral part of health care systems; policies & legislations; demand for expert NI increased; Post 2000 hardware and software development; wireless point-of-care, open source solutions; Internet;

THEORY

MODEL

FRAMEWORK

WHAT IS THE PURPOSE OF A NURSING THEORY?

CLINICAL PRACTICE

ADMINISTRATION

RESEARCH

ACADEME

What is the use of Nursing Informatics in these areas?

STANDARD INITIATIATIVES

Nursing Practice Standards ANA & JHACO Nursing Data Standards Health Care Data Standards Organizations

LANDMARK EVENTS Early conferences, meetings Early academic initiatives Initial ANA initiatives Initial National League of Nursing initiatives Early international initiatives Initial educational resources Significant collaborative events

LANDMARK EVENTS
Year 1973 1977 Activity First Initial Conference: MIS for Public/Community Health Agencies First research; State-of-the-Art Conference on NIS First Nursing undergraduate course: Computers and Nursing 1982 First Annual National Nursing Computer Technology Conference First Newsletter: Computers in Nursing PLATO IV-CAI Educational Network System 1984 First Nursing Conference Journal: Computers in Nursing

LANDMARK EVENTS
Year 1984 Event ANA initiated: Council in Computer Application in Nursing First Directory of Educational Software in Nursing 1986 1990 1991 MEDINFO 86 : 5th World Congress on Medical Informatics Formation of ANA Steering Committee on Databases to Support Nursing Practice First Nursing Informatics Listserv First Summer Institute in Nursing and Healthcare Informatics 1992 ANA recognized 4 nursing vocabularies: HHCC, OMAHA, NANDA, NIC

LANDMARK EVENTS
Year 1993 Event AJN Network Online via Internet Formation of Nursing Informatics Fellowship Program 1994 1995 ANA NET online Nursing educators workshop First International NI Tele Conference First Weekend Immersion in NI (WINI) CARING Web site 1996 1998 1999 TELENURSE Project Initiated NursingCenter.com website Inaugural Virtual Graduation: Postmasters: ANP Certificate Program

LANDMARK EVENTS
Year 2000 2002 2003 2004 Event Computer-based Patient Record Institute (CPRI) 2000 Conference Strategy Conference for Health IT and eHealth Vendors First ISO Nursing standard: Integrated Reference Terminology Model for Nursing First ICN Research and Development Centre First Nursing Informatics Symposium at HIMSS

EHR

CPRI Computer-based Patient Record Institute (1992) Represents all stakeholders in healthcare, focusing on clinical applications of information technology (IT);

EHR

CPR Computer-based Patient Record (1993) 4 Major Areas of CPR Criteria

Management Functionality Technology Impact

 Davies Program developed the CPR into the electronic medical record (EMR) to EHR; Series of efforts were done to further develop the EHR; Impact:
avoidance of medication error non-duplication of ordered test improved care and patients safety online documentation

RESULTS
Ability to meet users demands fro rapid response Systems reliability Data capture Unique interfaces, user agreements, cultural changes , workflow revisions Window and menu customization; moves from paper-based to electronic system Mobile wireless workstations

THANK YOU!
Assignment: 1. Identify the key hardware components of a computer and the 4 basic operations of the central processing unit (CPU). 2. Enumerate the categories of software. 3. What are the key requirements for software designed to support nursing practice?