Ni theories, models, and frameworks

NURSING INFORMATICS

Theories, Models, and Frameworks

NURSING INFORMATICS

Is an established and growing area of specialization in nursing

All nurses employ information technologies in their practice.

“Computers are incredibly fast , accurate

and stupid.

Human beings are incredibly slow , inaccurate and

brilliant .

Together they are powerful beyond imagination”

Albert Einstein

Why do we NEED to study N.I?

In the 21st Century, information isdoubling every 5yrs , if not tripling in quantity and quality.

Information is POWERTechnology also facilitates the creative process in nurses, affording amazing vehicles for

patient education , teaching and learning , and providing general health promotion and prevention information on a global scale.

This can only become a common reality if nurses are comfortable working with computers and advanced technology while providing evidence based care for their clients .

The healthcare of our clients is largely dependent on information.

Every action taken depends on previous information and knowledge.

“THE HIGH TECH AND THE HIGH TOUCH”

WHAT DO WE NEED TO ACHIEVE NURSING

INFORMATICS?

SOFTWARE

HARDWARE

PEOPLE

“Nursing practice will be revolutionized and we will

truly be a profession of nurses with our own

classification systems, bibliographic systems, and

payment systems .”

We need to think outside the box?

We need to use the Internet to enhance our practice and provide tele-nursing care . We need to become wireless and conduct our

services using all the newer IT tools.

“ We have a long way to go, but if we utilize information technology effectively, informatics will become an integral part of our profession and the health care industry. I do believe we have the knowledge and perseverance and I

am convinced it will come to pass.”-Dr. Virginia Saba

INFORMATICS

What is informatics

1957 - First coined by Karl Steinbuch as “informatiks”.

1962 – Phillipe Dreyfus used “informatique”

Walter Bauer – translated it into “informatics”

What is informatics

Combined the terms “information” and “automation” which means automatic information processing.

What is informatics

A science that combines a domain science, computer science, information science and cognitive science.

Multidisciplinary science drawing from varied theories and knowledge applications.

What is informatics

a broad academic field encompassing human-computer interaction, information science, information technology, algorithms, and social science

What is informatics

Computer science, the study of complex systems, information and computation using applied mathematics, electrical engineering and software engineering techniques.

What is informatics

Information science is the study of the processing, management, and retrieval of information

In 1980, Scholes and Barber applied this new term to the art and science of nursing, coining the term, “nursing informatics”, which they defined as “...the application of computer technology to all fields of nursing-- nursing services, nurse education, and nursing research”.

WHAT IS HEALTH INFORMATICS

HEALTH INFORMATICS

Integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information.

A subdiscipline of informatics…

ACTIVITY

Present an illustration using the description delineating Health Informatics and its sub disciplines. Health informatics have subdomains such as medical

informatics, dental informatics, pharmacy informatics, nursing informatics, etc.

Each of these subdomains have integrated content and which are collaboratively working with each other.

ACTIVITY

Limit your illustration using only circles, squares and arrows and texts.

Use any application (paint, Msword, Ppt) in making your diagram.

Finally present the illustration using powerpoint.

Further explain your diagram.

CORRECT

HEALTH INFORMATICS

Dental Informatics

Nursing Informatics

Pharmacy Informatics

Medical Informatics

NURSING INFORMATICS

1985 – Kathryn Hannah;..is the use of information technologies in relation to any nursing functions.

NURSING INFORMATICS

1989 – Graves & Corcoran .. Is a combination of computer science, information science and nursing science designed to assist management and processing of nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care.

NURSING INFORMATICS

1994– ANA .. 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.

NURSING INFORMATICS

2001– ANA ..a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information and knowledge in nursing practice…

NURSING INFORMATICS

2001– ANA ..facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings. The support is accomplished through the use of information structures, information processes, and information technology

Differentiate

Health Informatics Nursing Informatics

SCOPE OF PRACTICE

P RACTICEE DUCATIONR ESEARCHA DMINISTRATION

NURSING INFORMATICS

SCOPE

Standard Areas of NURSING:

Nursing P ractice

Nursing E ducation

Nursing R esearch

Nursing Administration

COMPUTERS IN NURSING EDUCATIONS

COMPUTER Assisted Education PDA (Personal Digital Assistants) LCD Projectors Wireless Routers Desktops Laptops Smartphone VIDEOS/ANIMATIONS Distance learning Testing (NCLEX) Student and course record

management

COMPUTERS IN NURSING PRACTICE

Functions Records client information Provides access to other

departments Used to manage client

schedulingDOCUMENTAION OF CLIENT

STATUSAND MEDICAL RECORDS KEEPING

Provides access to standardized forms, policies and procedures

Access data about client that may be somewhere in the medical record or elsewhere in health care agency.

BEDSIDE DATA ENTRY records clients assessments, medication administration, progress

notes, care plan updating, client acuity and accrued charges

COMPUTER BASED CLIENT RECORD EMRs/CPRs

Provides easy retrieval of specific data such as trends in vital signs, immunization records, current problems

It can be designed to work providers about conflicting medications or client parameters that indicate dangerous conditions

ELECTRONIC ACCESS TO CLIENTS Used extensively in health care to assess and monitor clients

conditions Data accumulated from various electronic devices are stored for

research purposes Can monitor client Computerized diagnosis Telemedicine

PRACTICE MANAGEMENT Used to order supplies, tests, meals, and services, from other

departments Allows nursing service to determine the most costly items used by a

particular nursing unit. May provide information or decisions to modify budget, provide

different staffing, move supplies to different locations, or make other changes for more efficient and higher quality care


A. Human resources All employers must maintain a data a database on each

employee Administrators can use this database to communicate with

employees, examine staffing patterns, and create budget programs

B. Medical records management Allow client records to be searched for trends, number of

cases, most expensive cases, and client outcomes. Nurse informaticist can assist administrators with the design

and implementation of systems that allow such searches to be generated, analyzed, printed, and distributed.


C. Facilities management heating, air conditioning, ventilation, alarm systems are

computer controlled.

D. Budget and finance claims are transmitted much more quickly Can also effect cost-savings by reducing the desired

services time needed for accounts payable and receivables.

COMPUTERS IN RESEARCH

1. problem identification Useful in locating current

literature about the problem and related concepts

Helps in searching for existing documents, and e-mail to colleagues.

2. literature review Software facilitate searches,

contains thesauruses so that the most appropriate terms can be selected.

COMPUTERS IN RESEARCH3. research design

Search literature for instruments that have already been established or to design and test instruments that need to be developed for past study.

4. Data collection and analysis Helps create form for the collection of data

such as informed consent, demographic data, and recording forms.

Commonly used software for quantitative data analysis: SPSS ( statistical package for social sciences), SAS ( statistical analysis system), Sys STAT, MYSTAT

5. Research dissemination computer word processing programs are used

to author the final reports of research and send research to various readerships.

Help speeds completion or research projects

NI as a SPECIALTY

1992 – ANA established nursing informatics as a distinct specialty in nursing with a distinct body of knowledge.

INDIVIDUAL ACTIVITY

Use a Word Processor Explain how nursing informatics is considered as a

distinct specialty. Specifically describe the role of informatics nurses

compared to nurses of other fields of nursing. 200 words minimum..

INDIVIDUAL ACTIVITY

Use a Word Processor Use Times New Roman Font Size: 12.5 Line Spacing: 1.5 1 tab indent each paragraph Justify each paragraph Margins: 0.75” top, 0.75” bottom, 1” left; 1” right. Orientation: Portrait Paper Size: Long Bond Paper Title at Center (Make your own) Save File: Act1YourName.doc

Informatics Nurse Specialists

Is a professional with a formal RN graduate degree and passed the credentialing in nursing informatics of a state.


Nursing informatics specialists practice in a wide variety of roles that are ultimately aimed at improving patient care delivery and the nursing practice experience.


Some of those roles are:Project managerEducatorProduct developerDecision support/outcomes managerSystems analystConsultantProgrammerAdvocate/policy developerWeb developerCIO, CEO, CNOEntrepreneurResearcherSales and marketing

COMPONENTS of PRACTICE

Transformation of Data to Wisdom

Data – discrete entities that are described objectively without interpretation.ex. A systolic blood pressure, a nursing intervention, a patient problem, an outcome



Information– reflects interpretation, organization, or structuring of data. - are processed data

- data with meaning



Knowledge–transformation of information.- information that is synthesized so that relationships are identified and formalized



WISDOM–highest form of data transformation.- is the application of ethics in using knowledge.

COMPONENTS of PRACTICEC

om

ple

xity

Human Intellect

Data

Information

Knowledge

Wisdom

Group Activity

NURSING INFORMATICSCOMPONENTS

CORRECT

As an example, a single instance of vitals signs – heart rate, respirations, temperature and blood pressure – for a single patient can be considered a set of data.

CORRECT

A series of vital signs taken over time, placed into a context, and compared is considered information.

CORRECT

However, a dropping blood pressure, increasing heart rate, respiratory rate, and fever in an elderly, catheterized patient are recognized as being out of the norm. The recognition that this patient may be septic and in need of nursing and medical interventions reflects information synthesis (knowledge).

REGISTERED NURSES as KNOWLEDGE WORKERS

Knowledge work is the exercise of specialist knowledge and competencies.

ACTIVITY 3

Discussion Boards Check out our discussion board on

facebook (NI Page) Post your ideas under this topic

Nurses as knowledge workers 250 words minimum

SCREEN CASTING

Create a powerpoint presentation of your report.

Using the powerpoint report record as video + audio and edit the report for screencasting. Record the narration like you are explaining your slides on class.

Utilize your knowledge on video editing.Maximum minutes of screencast is 10

minutes only.Number of members per group = 3..no

exceptions.

COMPETENCIES

Research; Article search (Use of internet) Staggers, Gassert, and Curran, 2001 ANCC

Informatics Exam Content HIMSS (Healthcare Information and

Management Systems Society)

TERMINOLOGIES

What is the use of standard terminologies/languages?

What is a data set?What is nursing minimum data set

(NMDS)?Enumerate the different ANA-

recognized terminologies. Describe each briefly.

TENETS

Distinct specialty practice and body of knowledge

Includes both clinical and non-clinical

Supports nurses to improve quality of care and welfare of health care consumers

Focus is delivering right information to right person at the right time

TENETS

Human factors concepts are interwoven in practice

Ensure confidentiality and security of data and information and advocates privacy

Promotes innovative, emerging and established information technology

Collaborates with and is closely linked to other health-related informatics specialties

ELECTRONIC HEALTH RECORD


…any information related to the past, present, or future physical/mental health, or condition of an individual. The information resides in electronic system(s) used to capture, transmit, receive, store, retrieve, link, and manipulate multimedia data for the primary purpose of providing healthcare and health related services..


Increased patient safety: All information about the patients existing conditions, allergies and drug intolerances is available when Physicians need it, where they need it so that they can make the best decisions for their patients.

Increased efficiency: A single source of accurate patient data means Physicians don't need to spend time logging in to different specialist clinical systems or contacting other healthcare institutions for information.

Trend and data analysis: A central clinical repository of clinical information means that information can be mined and analyzed to contribute to more effective healthcare delivery in the future, and can give a better understanding of trends, patterns and epidemiology in public health.

HIPAA and Technology

Influx of new technology is creating implications for the protection of privacy and security.

Simple precautions to secure client info: Use data encryption Use password when logging on, and a

time-out to reactivate the password If using PDA, disable the infrared ports

Privacy – Confidentiality – Security

The role of staff nurses as the protector of patient information is becoming more crucial as more health care information becomes part of the medical record and as it becomes more available electronically instead of on paper.


The staff nurse may be ask to provide information such as a printed medical administration list from an electronic medical record to the patient, the patient’s family member, a medical student, or an attending physician.

Accountability among nurses is highly a concern.


Privacy is a means of protecting health information so that it is not used or disclosed except as authorized by the individual. It protects the privacy of the individual.


Confidentiality means that information, once allowed to be disclosed by the individual, will not be shared without the permission of the individual thereby keeping it confidential.

Example: Nurses should not talk to anyone except those under privileged communication regarding patient’s information, including security information.


Security is a means by which data is stripped of identifiers that might otherwise be used to identify a given individual. Ex. Use of passwords and PIN Codes

What is a Clinical Information System (CIS)?

• Collections of Information Technology Applications equaling a repository (database) of information for client care

• Contains information about client – history of illness, interaction with providers, genetic, environmental and social data

• Creates record of status of decisions, actions underway and information to assist in performing targeted actions

What is an Electronic Record (EHR)?

• Other common names – computerized patient record (CPR), electronic medical record (EMR) and the electronic patient record (EPR)

• Part of CIS• Resides in a software

program providing the health provider an instrument to obtain clinical information and transcribe data into the computer

• Classified in three groups: (1) Office Based (2) Web-based (3) Handheld or Wireless System

ADVANTAGES- Instant Access- Legibility- Safer data (protects from

loss)- Confidentiality- Flexible Layout- Integration with other info

resources- Electronic data- Continuous data processing- Assisted Search- Tailored Paper Output- Always Current!

Clinical DSS focus in EHR for Nurses

CPOE – Computerized Prescriber Order Entry

BCMA – Bar Code Medication Administration

Integrated EHR Features

Digital Imaging (Laboratory Informatics)




Nursing Documentation


Nursing Documentation

Note: ALL TOPICS COVERED FOR PRELIM..are in this presentation.

PRELIM EXAM in TWO PARTS Written exam (26 items; Multiple Choice, 19 items

Crossword puzzle) Hands-on

POWERPOINT : Animations/Hyperlinks WORD: Formatting MOVIE MAKER : EFFECTS/TRANS/TIMING

Health & Medicine

Ni theories, models, and frameworks