Nursing Informatics
Ann Shepard, RNC, MSN
Director, Customer Support Services
Information Technology
Mercy Medical Center-Des Moines
Objectives
Introduce Nursing Informatics
Certification for Nursing Informatics
Application of Nursing Informatics
Future of NI
How it all began….
Late 1960’s first computer systems were
implemented in hospitals
Computer nurses began to appear in hospitals
Excellentclinicians
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 specialty
Disconnected parts
Roles, titles, and responsibilities varied
Definitions similar, conceptual models
considered, research in varied directions, all
good—standard languages
Panel assembled to help sort out the pieces
Definitions
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.”
Image, p. 227
1996—Turley defined Nursing Informatics as the
intersection point with Nursing Science,
Computer Science and Information Science.
1995—Graves et al, began to incorporate
knowledge as a product of the sciences into the
definition.
National Center for Nursing
Research
Began in 1988
Noted scholars met to discuss priorities for nursing research
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:
[Link]
American Nurses Association
Recognized as a specialty in 1992
Defined NI, outlined roles and responsibilities and
developed standards for practice.
Certification for generalist
[Link]
ANCC (American Nurses Credentialing Center)
American Nurses Association
1994, Scope of Practice for Nursing Informatics
“Nursing 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 today
2001, Scope and Standards of Nursing
Informatics Practice
NIis an evolving field—expect change in definitions
Three categories of definitions
Technology focused
Conceptually focused
Role-Orientated
To order or for additional info on the booklet: [Link] (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
Certification
Began in 1995
First computer based exam—able to take at any
time at any approved testing location
Knowledge expected of a NI generalist
Focus areas of knowledge—from 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 Design
Conducting need and feasibility assessments
Process flow charting
Understanding requirements
Quality management and customer satisfaction
concepts
System Implementation and
Support
Project management strategies
Policies and procedures
Education and training
Communication
Vendormanagement
Customer expectations
System Testing and Evaluation
Willit do what we hoped it would for the costs we
thought in the time frame we planned?
This is our strength--assessment
Design process
Testing the system
Reviewing output of the system—reports
Measurement of pre-system goals
Less time, more efficiently, legibility, accurate data, single
entry, etc
Human Factors
Ergonomics
Right tool for the location, the care delivered, the
care provider
Screen flow, use of data for decisions
Computer Technology
Understanding of the actual technology
Networks
Personal computers
Portable devices
Operating systems
Software
Information/Database
Management
Understand database architecture—how data is
stored and accessed
Nursing structure
Nomenclature/vocabulary
Taxonomies and Coding Schemes
ICD-P, CPT
Nursing Minimum Data Sets
NIC,NOC, NANDA,
Theories
Nursing Communication
Management Systems
Information
Computer
Behavioral
Change theory
Organizational behavior
Learning
Professional Practice/Trends
and Issues
Ethics
Privacy
Roles of NI
ProjectManager Researcher
Educator Consultant
Advocate/Policy Developer Product Developer
Decision Support / Outcomes Manager
Future of Nursing Informatics
Emerging roles
CIO, Entrepreneurs, Product Developers, Web
design, Independent Consultants
Challenges
Integration of data—duplication often
Inability to access data for decision making
Unique distinctions between roles has not been
defined--competencies
Questions?
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.
National 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.
