Nursing Informatics:Nursing Informatics:General purposesGeneral purposes

Presenter: MRS HEENA MEHTAS.Y.M.Sc. NURSING

IntroductionIntroduction

The worlds of health care, communication, and information technologies are ever growing, separately and together.

As nurses in the community expand their practice definition to embrace new information technologies, opportunities for improved health care to populations seem endless.

Introduction……………..Introduction……………..

This advancement is seen as a union of health care technology with information and communications technology, nurturing the design and implementation of health care management information systems in a variety of clinical practice settings.

Community Community based setting based setting environmentenvironment

Acute care in Acute care in hospital settinghospital setting

New technologyNew technology

What is Informatics?What is Informatics? Organizations such as hospitals and community-based

agencies such as public health departments and home agencies use information and communications technologies to collect, restore, retrieve, analyze, and present client care data in the care delivery settings.

Decisions related to client care continue to increase in complexity, with the need for rapid, accurate information for clinical decisions making as a priority for effective care.

Health InformaticsHealth Informatics Application of information technology to the health

sector has tremendous potentiality for efficacy of health care delivery institutions and provision of cost-effective health care.

Health care delivery institutions will need and use information technology to meet their client demands and stay competitive, since, the future for them lies in cost-effective health care.

Health InformaticsHealth Informatics

That is why a host of solutions, standards and services are emerging to meet needs of the health sector.

Application of information technology to the domain of health care delivery is referred to as Health Informatics.

.

What is Nursing Informatics?What is Nursing Informatics?

Nursing informatics is a field within the field of health informatics, where people who have a nursing degree are involved in the implementation of a computer application in a hospital, nursing home, doctor’s office, public health clinics, or other healthcare setting.

Definition………..InformaticsDefinition………..Informatics

Informatics generally can be defined as the art and science of turning datainto information. The more recently informatics defined as the study of theapplication of computer technology and statistical techniques to themanagement of information.

Definition…Nursing InformaticsDefinition…Nursing InformaticsANAANA

Nursing informatics (NI) is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.

NI supports consumers, 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.

Nursing Informatics uses nursing science, computer and communicationstechnologies to produce effective and efficient client outcomes for individualsand communities.

Nursing Informatics… DefinitionNursing Informatics… Definition

Nursing Informatics… DefinitionNursing Informatics… Definition

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.”

Nursing Informatics - DefinitionNursing Informatics - Definition

“The use of technology and / or a computer system to collect, store, process, display, retrieve, and communicate timely data and information in and across health care facilities that:

Administer nursing services and resources; Manage the delivery of patient and nursing care; Link research resources and findings to nursing practice; Apply educational resources to nursing education” (Saba,

1996).

How it all began….How it all began….

Late 1960’s first computer systems were implemented in hospitals

Computer nurses began to appear in hospitals Excellent clinicians Technically curious and willing to try new things

Nursing Informatics - FocusNursing Informatics - Focus

Nursing informatics focuses on the use of “nursing information system” (NIS) to administer nursing resources:

To assist in effective information management; Monitor the quality, effectiveness, and outcomes

associated with the provision of care; Protect the confidentiality and privacy of patient data.

Conceptual FrameworkConceptual Framework

Data Information Knowledge

Nursing Process

Information and Communication Technology

minute level Synthesis

(raw facts) (interpreted facts) (synthesized information)

Nursing Nursing Classification Classification

SystemsSystems

Reasons for Classification System Reasons for Classification System DevelopmentDevelopment

To standardize classification To expand nursing knowledge To develop information systems To teach decision making To determine nursing costs To allocate nursing resources To communicate nursing to non-nurses To link nursing knowledge

Basic conceptsBasic concepts Basic concepts for information systems:

Nursing data: refers to unstructured raw facts; Are discrete entities; Lack interpretation. Forms the basis for a nursing information system.

Nursing information: data that has been given shape and has been interpreted.

Nursing knowledge: synthesized information derived from the analysis of data that has been processed.

Nursing Data StandardsNursing Data Standards

Needed for the management, documentation and communication of nursing diagnosis, interventions, and outcomes (patient and nursing sensitive).

researched and supported by the ANA Council on Computer Applications in Nursing and the NLN’s Council for Nursing Informatics.

Nursing informationNursing information Nursing information systems exists within the background

of the total continuum of the “integrated patient record system”.

Health care is, and will continue to be an information-intensive attempt.

Information is a critical resource in the health care delivery environment.

Nursing Practice is essentially an information-processing activity.

Nursing information……Nursing information…… Nursing information is essential to the accuracy of

integrated systems (both health care delivery and information systems).

Patient-specific data are the central point of a totally integrated patient-record system.

Atomic-level data, captured within a Nursing Information System will be used for many purposes.

Nursing KnowledgeNursing Knowledge Data and data elements required for nursing

information systems are developing. To ensure high-quality practice, nurses need

access to sources of data that are ”beyond institutional, patient-specific data”.

“There will always be a need for human interpretation of computer-processed data”.

Nursing Classification Nursing Classification System’s Integration System’s Integration Into Nursing PracticeInto Nursing Practice

Information systems development.

Need for standards-based, evidenced based practice. guidelines.

Need for standardized language across the continuum and across nursing practice settings.

Integrated from a trans-disciplinary, integrated healthcare delivery perspective.

The Need of Nurse Informaticists The Need of Nurse Informaticists

Analyze clinical and financial data Promote and facilitate access to resources and

references Provide nursing content to standardized languages Enable cost savings and productivity goals Source

The Need of Nurse The Need of Nurse Informaticists ……….Informaticists ……….

Nurses do not want to be passive consumers of technology

Nurses want devices that are integrated, voice activated, handheld, use biometrics, provide translation, are portable, are wireless, auto settle, and are “smart”

Greater nurse satisfaction leads to greater patient satisfaction

The Benefits of Nurse Informaticists The Benefits of Nurse Informaticists Nurse Informaticists promote and facilitate access to

resources and references Support for their mission to deliver high quality,

evidence-based care Support for better service by facilitating true

interdisciplinary care Improvement in key relationships with providers & care recipients Enable cost savings and productivity goals Facilitate change management Enhance continuity of care

Trends In Nursing InformaticsTrends In Nursing Informatics  

IntroductionIntroductionTechnologies emerging in the fields of telecommunications, video and digital imaging, and microprocessing are shaping the future of nursing practice. To measure up to the future needs of nursing, nurses of today must have the vision and desire to become computer aware and technologically literate.

DefinitionDefinition Nursing Informatics (NI) is the specialty that integrates nursing

science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data 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. (Scope of Standards of Nursing Informatics Practice -American Nurses Association 2001)

Nursing informatics refers to electronic information combined with nursing and any aspect of clinical practice, administration, research, or education (Guenther, 2006).

GoalGoal The goal of Nursing Informatics is to improve the

health of populations, communities, families, and individuals by optimizing information management and communication. This includes the use of technology in the direct provision of care, in establishing effective administrative systems, in managing and delivering education experiences, in supporting life-long learning, and in supporting nursing research.

Standards of practiceStandards of practice

Organized around a general problem-solving framework thatclosely resembles the familiar nursing process of Assessment Diagnosis Planning Identification of Outcomes Implementation Evaluation Supports all facets of Informatics Practice, including thosewithout technology

SolutionSolutionAn informatics solution may encompass technology and non technology products such as:Developing a databasePurchasing a new computer applicationCreating nursing vocabularyDesign informatics curriculaCreating a spreadsheetTailoring an application to a particular environment Designing a research study to describe required informatics competenciesDescribing information flow in a process redesignCreating a structure for information presentation

HistoryHistory

For three decades or more, nurses have held informatics roles and been key stakeholders in developing, implementing, an devaluating informatics solutions. Although implementing

informatics solutions continues to be very important, more recently informatics nurse specialists have worked to develop and refine nursing’s language, implement tele-health systems, establish NI educational programs and expand the focus.

Nursing Informatics (NI) – futureNursing Informatics (NI) – future Ubiquitous computing is becoming a reality and the continued innovation and

miniaturization of technology is evident. Consequently partnering between nurses in all specialties and new technologies is becoming imperative.

Technological innovations are challenging many traditional processes, Telecommunications technologies are one set of tools used in nursing practice.

Core competencies across informatics specialties should be identified in the near future. The distinctions among informatics specialties will continue to blur.

The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future, making nursing practice and NI, in particular, more international in practices with world-wide standards, competencies and curricula.

Trends In Nursing InformaticsTrends In Nursing Informatics

Mature and Ubiquitous Technology Solutions Mid-Stage Technology Solutions Emerging Technology Solutions

Mature and Ubiquitous Technology SolutionsMature and Ubiquitous Technology Solutions

Order Management & Communication Clinical Repositories Departmental Systems (LAB, RAD, etc.) Picture Archiving Communication System(PACS) Online Electronic Bed Management Systems Departmental Scheduling Staff Scheduling Intranet/Internet Based Reference Materials (Orders,

Protocols, Drug Monographs) Phones, Pagers, In-house Communication Devices

Wide Variety of Fixed & Mobile Devices

Clinical SystemsClinical Systems

Order Management & CommunicationOrder Management & Communication Clinical RepositoriesClinical Repositories Departmental SystemsDepartmental Systems PACSPACS

Order Management & Order Management & CommunicationCommunication

Communication management as a second-order management function:

CLINICAL REPOSITIORIESCLINICAL REPOSITIORIESThe solution is optimised for healthcare enterprises and collects all digital medical images, electronic health records and associated metadata related to patient care.

DEPARTMENTAL SYSTEMDEPARTMENTAL SYSTEM Understand

ing the organization and functions of the hospital

Quality of care -

Leadership -

PACSPACS n. picture archiving and

communication system: an electronic system enabling the storage of digital images on electronic media, for later retrieval and subsequent display on high-resolution monitors.

Enterprise SystemsEnterprise Systems Online Electronic Bed Management Systems Nurse assignments are no longer hand written Determine the real-time census of units Reports available to track lengths of stay Monitor delays in patient movement Determine bed availability quickly Spend less time negotiating on the telephone Departmental Scheduling Systems Deployed as standalone or in centralized models

Administrative & General Workflow Staff Scheduling Allows healthcare facilities to create templates for the various

skills and skill mixes that exist across their units and facilities Using this template a computerized system optimizes staffing based on identified and known constraints.

Facilitates identification of staff preferences in mind Logic identifies when a skill mix is off Logic identifies when a nurse is being asked to go to an area that

she/he is not trained for Time required for schedule creation has decreased significantly Staff satisfaction has improved

Intranet Based Reference Materials (Orders, Protocols, Drug Monographs)

Phones, Pagers, In-house Communication Devices Wide Variety of Mobile Devices Designed to augment clinical workflow needs can be

personalized to the care giver and specific documentation or data entry needs

Laptops PDAs Notebooks COWs (Computers on Wheels) Many Others

Mid-Stage Technology SolutionsMid-Stage Technology Solutions

Online and Integrated Electronic Patient Documentation Integrated Hemodynamic Monitors (Vitals Signs) with EMR Hand-held Devices for Data Collection & Input Online Fully Integrated Medication Administration Record Online and Integrated Rules and Alerts CPOE – Computerized Provider Order Entry Bar Code Technology Access and Security Technology Sophisticated Implementation Methodologies Organization of Nursing Practice through Technology- Time and

Motion Templates, Nomenclature/Data Standardization Tools, Care Plan Standardization and Tool Sets

Clinician’s Access to patient record system Attending Physician, Nursing, Consulting

Physician(s), Respiratory Care, Case Management Nutritional Services, Risk Management, IV Team,

Patient Financial Services, Infection Control Wound Management, Pastoral Care, Clinical Process

Improvement, Cardiology, PT/OT/Speech, Others.

Barriers Record must be on unit All clinicians and support, personnel must walk to

location of chart One person can access the chart at a time Legibility of chart input Timely filing of data results into chart Finding clipboard for most current information Redundant information

Clinician’s Access to online record Electronic patient data barriers:• Systems Availability• User Acceptance

Integrated Hemodynamic Monitors (Vital Signs) with EMRVital signs are automatically updated to the patient EMREliminates paper documentation and accurately captures patient information at the point of careDevices are fixed in the patient room or mobile on COWs (Computers on Wheels)

Hand-held Devices for Data Collection & InputAssist with obtaining, verifying, and communicating dataCardiology, Transplant, and other clinically significant data can be entered directly onlineEliminates the need for bulky data collection sheetsEnhances the ability for version control of data entry Documents

Online Fully Integrated Medication Administration Online Fully Integrated Medication Administration RecordRecordSignificant time reduction associated to documenting medicationsSignificant time reduction associated with transcription of medications to paper MARDecreased transcription errorsIncreased patient safety

Online and Integrated Rules and Alerts Online and Integrated Rules and Alerts (Workflow)(Workflow)Drug-allergy alerts based on order entry functionalityDrug-drug interaction alertsAlerts for abnormal lab values and vital signsAlerts for new ordersAlerts for order renewalsAlerts for scheduled patient events

CPOE – CPOE – Computerized Provider Order EntryComputerized Provider Order EntryNurses no longer struggle to read physician handwritingReduces verbal ordersAll providers can enter orders directly online - Integrated rules and alerts, Integrated allergy checkDecreases chances for transcription errorReduces delays in patient care

Bar Code Technology Barcodes on patient bands and medication

packaging helps to double check that the right medication is being given to the right patient at the right time

System alerts the nurse immediately if any inconsistencies or potential problems exist

Internal back-up systems are in place to back-up information regularly so a MAR can be printed in the event of system downtime

Integration with electronic MAR and documentation systems becoming more common place

Access and Security Technology Single Sign-On Biometric

Sophisticated Implementation Methodologies Sophisticated planning and implementation methodologies

take the guess work out of project management Include workflow, communication, risk mitigation, system

design and analysis, as well as overall task management activities

Tightly integrated financial management tools to ensure projects stay on track and in budget

Organization of Nursing Practice through Organization of Nursing Practice through TechnologyTechnology

Time and Motion Templates Nomenclature/Data Standardization Tools Care Plan Standardization and Tools Sets

Emerging Technology Solutions Emerging Technology Solutions

National Patient Databases for comprehensive patient record across disparate providers

Patient Health Cards – contain all medical records and information

Advanced Biometric Access and Security functionality

Voice recognition within electronic medical records Hands free communication tools

Journals on Informatics Nursing CIN: Computers Informatics Nursing (formerly,

Computers in Nursing) Journal of the American Medical Informatics

Association (JAMIA) International Journal of Medical Informatics (IJMI) International Journal of Bio-Medical Computing

(IJBC) Online Journal of Nursing Informatics (OJNI)

SUMMARY MEANING AND DEFINITION NURSING INFORMATICS HISTORY NURSING CLASSIFICATION SYSTEM BASIC CONCEPT

NEED OF NURSING INFORMATICS BENEFIT TRENDS AND DEFINITION TRENDS IN NURSING INFORMATICS.

ConclusionConclusion

Nursing informatics is a developing field of study that is highly interdisciplinary. It is strongly connected to education, business, and computer science.

BIBLIOGRAPHYBIBLIOGRAPHY