Integrating Informatics Competencies

and Digital Health in Nursing Education

WNRCASN, Victoria, B.C.

Wednesday, February 15th, 2017

South Pender Island Room

Hotel Grand Pacific, Victoria, B.C.

Elizabeth Borycki RN PhD

Glynda Rees Doyle RN MSN

Workshop Objectives

1.Participants will have a clear understanding of

CASN’s digital health support tools for

undergraduate nursing education

2.Participants will leave with a deeper

understanding of where and how digital

health intersects with nursing care

3.Participants will learn strategies for integrating

this content into nursing programs.

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3

TIME ITEM AGENDA PRESENTER(S)

1200 - 1230 LUNCH

1230 - 1245 1 Welcome and introductions Elizabeth Borycki, RN, PhD & Glynda

Rees Doyle, RN, MSN

1245 - 1315 2 Project overview

Entry-to-practice informatics competencies

Nursing informatics teaching toolkit

Consumer Health Solutions Resource

Elizabeth Borycki, RN, PhD & Glynda

Rees Doyle, RN, MSN

1315 - 1445 3 Case study activity

Whiteboard animation video with group discussion to explore the

intersection of digital health and nursing care

Elizabeth Borycki, RN, PhD & Glynda

Rees Doyle, RN, MSN

All participants

1445 – 1500 BREAK

1500 - 1600 4 Case study activity (continued) Elizabeth Borycki, RN, PhD & Glynda

Rees Doyle, RN, MSN

All participants

1600 – 1650 5 Discussion & networking All participants

1650 - 1700 6 Wrap-up and closing statements Elizabeth Borycki, RN, PhD & Glynda

Rees Doyle, RN, MSN

Canadian Association of University Schools of Nursing

The national voice for nursing education,

research, and scholarship and represents

baccalaureate and graduate nursing

programs in Canada.

DIGITAL HEALTH NURSING INFORMATICS TRAINING PROJECT

http://www.casn.ca/education/digital-

healthnursing-informatics-casn-infoway-

nurses-training-project/

Canada Health Infoway (Infoway)

A not-for-profit corporation funded to…

With their partners, Infoway helps accelerate the development, adoption and effective use of digital health solutions across Canada

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Project Background

• Since 2011, CASN and Canada Health Infoway have partnered on a series of projects to enable the integration of digital health into nursing curricula

• They have developed a series of guideline documents and tools to support faculty through a Digital Health Nursing Faculty Peer Leader Network

http://casn.ca/wp-content/uploads/2014/12/in

fowaytoolkit.jpg

http://www.casn.ca/2014/12/casn-entry-practice-nursing-

informatics-competencies/

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The Digital Health Nursing Faculty Peer Network

49 NURSING SCHOOLS 11 PROVINCES

Digital Health Nursing Faculty Network Peer

Leaders

Lynn Nagle (Chair) University of Toronto

Antonia Arnaert McGill University

Richard Booth Western University

Elizabeth Borycki University of Victoria

Glynda Rees Doyle British Columbia Institute of Technology

Craig Duncan Laurentian University

Jodi Found Saskatchewan Polytechnic

Karen Furlong University of New Brunswick

Jessie Johnson St. Francis Xavier

Manal Kleib University of Alberta

Digital Health

“Digital health refers to the use of information technology/electronic communication tools, services and processes to deliver health care services or to facilitate better health. Infoway’s vision is healthier Canadians through innovative digital health solutions.”

https://www.infoway-inforoute.ca

10

“In all types of health care organizations, nursing is the hub of the information flow. Developing the science and technology of nursing informatics will enhance the information available to nurses for clinical practice, management, education, and research and will facilitate the role of nurses as communicators." (Brennan, 1996)

Nursing Informatics

Nursing Informatics is…

…the "science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide."

(IMIA Special Interest Group on Nursing Informatics, 2009)

Bernstein, Jay H. (2009). The Data-Information-Knowledge-Wisdom Hierarchy and its Antithesis.

Proceedings North American Symposium on Knowledge Organization Vol2. Available at: http://dlist.sir.arizona.edu/2633

Health Informatics has the potential to: 1.Improve patient safety and quality of care

• Improves communication among health care team and patients

• Makes medical records accessible to health care providers and patients (in real-time)

2.Improve the health of populations • Predictive modeling to identify patients at risk • Bio-surveillance tools • Genomics • Teleheath

3.Reduce the cost of health care

https://cnia.ca/

CASN Competencies Framework

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CASN Over-Arching Nursing

Informatics Competency

• Students use information and

communication technologies to support

information synthesis in accordance with

professional and regulatory standards in the

delivery of patient/client care.

http://www.casn.ca/en/Whats_new_at_CASN_108/items/123.html

CASN Nursing Informatics Competencies • Foundational

– hardware (PCs, tablets, mobiles, modems, blue-tooth, flashdrives)

– application (email, texting, podcasts, blogs, social networks, word, excel,

D2L)

• Competency 1: Information and Knowledge Management

– Uses relevant information and knowledge to support the delivery of evidence-

informed patient care.

• Competency 2: Professional and Regulatory Accountability

– Uses ICTs in accordance with professional and regulatory standards and

workplace policies.

• Competency 3: Information and Communication Technologies

– Uses information and communication technologies in the delivery of patient/

client care.

http://www.casn.ca/en/Whats_new_at_CASN_108/items/123.html

Information and Knowledge Management

• Lit reviews, scholarly articles, evidence-informed decision making

• Uses patient data to support decision making

• Assist patients and families to use ICTs to manage their health

• Understands EHRs

• Understands importance of using standardized nursing data to advance knowledge and articulate nursing

• Evaluates data from multiple sources to inform practice

Professional and Regulatory Accountability

• Privacy and confidentiality

• Advocates for ICTs to deliver safe quality

patient care

• IDs and reports system failures/problems

• Functions appropriately if system unavailable

• Uses professional judgment with ICTs

• Recognizes need for nurse input into systems

Information and Communication

Technologies

• Identifies and uses variety of ICTs (hemodynamic

monitoring, CBGs, EHRs, point of care)

• Uses decision support tools to assist judgment and

deliver safe quality care

• Uses ICTs to support not interfere with nurse-

patient relationships

Information and Communication

Technologies (cont.)

• Describes variety of information systems (CPOE,

clinical documentation, MARs)

• Knows difference between EHR, PHR, EMR

• Describes benefit of informatics to improve health

systems and quality of interprofessional patient

care

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Teaching Digital Health

http://www.casn.ca/wp-content/uploads/2015/03/file0002120440786.jpg

Consumer Health Solutions

Integration of digital and consumer

health solutions (CHS) content in

nursing education

• Increased faculty knowledge

about CHS

• Readiness to integrate digital

health/CHS into

courses/curriculum

• Presence of learning

opportunities

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http://www.casn.ca/wp-content/uploads/2015/03/file0002120440786.jpg

Consumer Health Solutions Resource

Detailed exploration of 6 bourgeoning

areas of consumer health solutions

and accompanying learning

activities for curricular

integration.

http://www.casn.ca/wp-content/uploads/2015/03/file0002120440786.jpg

Sample Learning Activity

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Whiteboard Animation: Classroom Learning Activity

http://www.casn.ca/2016/03/whiteboard-animation-student-nurses-story-social-media-use/

DISCUSSION TIME

30 https://www.youtube.com/watch?v=5U7FZB-Z9Mk&feature=youtu.be

COFFEE BREAK

ADDITIONAL RESOURCES

The Canadian Nursing Informatics Association

• To provide nursing leadership for the development of Nursing/Health informatics in Canada.

• To establish national networking opportunities for nurse informaticians.

• To facilitate informatics educational opportunities for all nurses in Canada.

• To engage in international nursing informatics initiatives.

• To act as a nursing advisory group in matters of nursing and health informatics.

• To expand awareness of Nursing Informatics to all nurses and the healthcare community.

https://cnia.ca/education/resource-documents/

Canadian Nurses Association

• “CNA believes that information management and communications technology are integral to nursing practice.

• Competencies in information management and the use of communications technology are no longer add-ons to traditional methods of health-care delivery. Rather, these competencies are an integral part of health care and nursing practice.”

http://cna-aiic.ca/en/on-the-issues/best-nursing/nursing-informatics

Canada Health Infoway

A national, federally-funded,

not-for-profit organization

created in 2001 to foster the

development and adoption of

electronic health records

across Canada.

https://www.infoway-inforoute.ca/en/

• founded in 1975, has actively

initiated professional protocols for

using computer systems in

Canadian health care.

• Canada's Health Informatics Association provides access to a diverse community of accomplished, influential professionals who work passionately to make a difference in advancing healthcare through information technology.

http://www.coachorg.com/en/index.asp

COACH

http://www.thetigerinitiative.org

Technology Informatics Guiding Education Reform

Clinical and Systems Transformation Project

A join undertaking between Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care to complete a significant transformation of

clinical practices and systems.

http://www.providencehealthcare.org/careers/clinical-and-systems-transformations-cst-0

Position Statements & Guidelines on

Social Media

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Nurses Association of New Brunswick. (2012). Practice

Guidelines: Ethical and responsible use of social media

technologies. Fredericton, NB: Author.

http://www.nanb.nb.ca/media/resource/NANB-

PracticeGuideline-SocialMedia-E.pdf

Canadian Nurses Association. (2012). When Private Becomes

Public: The ethical challenges and opportunities of social

media. Ottawa, ON: Author.

https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_in_practice_feb_2012_e.pdf?la=en

Canadian Nurses Protective Society. (July 2012). Social

Media. infoLAW, 19(3), 1‐2.

http://www.cnps.ca/upload-

files/pdf_english/social_media.pdf

College of Registered Nurses of British Columbia. (2012).

Social Media: Professionalism, nurses and social media.

https://www.crnbc.ca/Standards/Confidentiality/Pages/Soci

alMedia.aspx

College of Registered Nurses of Nova Scotia. (2012). Position

Statement: Social Media. Halifax, NS: Author.

https://crnns.ca/wp-

content/uploads/2015/02/PositionStatement_SocialMedia.p

df

College & Association of Registered Nurses of Alberta.

(2011). CARNA Social Media Guidelines. Calgary.

http://www.nurses.ab.ca/Carna-

Admin/Uploads/Social_Media_Guidelines.pdf

Association of Registered Nurses of Newfoundland and

Labrador. (2012). Position Statement: Social Media. St

John’s.

http://www.arnnl.ca/documents/publications/Position_Stat

ement_on_Social_Media_2013.pdf

Social Media NurseONE : “Teaching Health Information Science for Health Care Instructors Handbook activity topic 1 to 4”, by Pasquale Fiore (2013) http://www.nurseone.ca/~/media/nurseone/files/en/health_sciences_information_course%20announcement_en.pdf

“HEALTH ON THE NET FOUNDATION”…. to guide the growing community of healthcare consumers and providers on the World Wide Web to sound, reliable medical information and expertise. In this way, HON seeks to contribute to better, more accessible and cost-effective health care.

Evaluating healthcare websites

https://www.healthonnet.org

Standardized Terminologies

C-HOBIC:

• Suite of standardized clinical outcomes reflective of nursing practice that can be captured to understand how nursing practice impacts patient outcomes in Canada.

• Currently in multi-provincial use in Canada,

• Additionally, the CHOBIC set of data elements is expressed in the International Classification for Nursing Practice (ICNP®) and is currently being mapped to SNOMED CT.

• http://c-hobic.cna-aiic.ca/about/default_e.aspx

• https://www.nlm.nih.gov/research/umls/Snomed/nursing_terminology_resources.html

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SNOMED CT

• In 1999 the American Nurses Association acknowledged the Systematised Nomenclature of Medicine, Clinical Terms (SNOMED CT®) as "the clinical reference terminology to support the integrated electronic health record for nursing." SNOMED CT® was developed by the College of American Pathologists as a reference terminology representing a broad array of health care concepts.

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ICNP

• The International Classification for Nursing Practice (ICNP®), developed by the International Council of Nurses, is a classification of nursing phenomena, actions, and outcomes that provides a unifying framework into which regional nursing languages, vocabularies, and classifications can be crossed mapped. In a collaborative effort NANDA International & ICNP® are in the process of identifying how NANDA® diagnoses are represented in ICNP®.

• http://www.icn.ch/images/stories/documents/pillars/Practice/icnp/ICNP_FAQs.pdf

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Thank You!

Elizabeth Borycki emb@uvic.ca

Glynda Rees Doyle

Glynda_doyle@bcit.ca www.healthedtech.net

http://opentextbc.ca/clinicalskills/