CHAPTER 7

Nursing
Informatics as a
Specialty

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Objectives

 Describe the nursing informatics specialty.

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 Explore the scope and standards of nursing informatics practice.
 Assess the evolving roles and competencies of nursing informatics practice.
 Appreciate the future of nursing informatics in our rich, technology-laden
healthcare environments.
Introduction

 Nursing informatics (NI) is an established, yet ever-evolving specialty.

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 Those choosing NI as a career find it full of numerous and varied opportunities.
 Previously, most nurse informaticists entered the field by showing an
understanding and enthusiasm for working with computers.
 Now, nurses have many educational opportunities available to become formally
trained in NI to become an informatics nurse specialist (INS).
Nursing Contributions to Healthcare Informatics

 Nursing has been involved in the purchase, design, and implementation of

information systems since the 1970s.

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 Nursing informaticists have been instrumental in developing, critiquing, and
promoting standard nursing terminologies to be used in health information
systems.
 Computers have revolutionized:
 The way individuals access information
 Educational and social networking processes
Scope and Standards

 NI meets the following needs for health informatics:

 Provides a nursing perspective

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 Showcases nursing values and beliefs
 Provides a foundation for nurses in NI
 Produces unique knowledge
 Distinguishes groups of practitioners
 Emphasizes the interest for nursing
 Provides needed nursing language and word context
The Overarching Standards of Practice

 According to ANA:
 Incorporate theories, principles, and concepts from appropriate sciences into

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informatics practice.

 Integrate ergonomics and human-computer interaction (HCI) principles into

informatics solution design, development, selection, implementation, and
evaluation.

 Systematically determine the social, legal, and ethical impact of an informatics

solution within nursing and health care.
Informatics Nurse Specialists (INSs)

 Their typical roles cover more than one functional area.

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 Informatics solutions are more closely integrated with the delivery of care.
 Telehealth is considered an integrated functional area that is a dynamic health
information technology.
 As nursing, information, computer, and cognitive sciences continue to evolve,
so will NI functions.
Need for Nursing Informatics (NI)

 NI has become an essential nursing specialty with the introduction of computers

and the EHR to health care.

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 Clinicians are learning to use new technologies and incorporate them into their
already busy days.
 According to one estimate, nurses spend as little as 10–15% of their days with
their patients and as much as 28–50% of their day documenting.
 Assisting nurses to incorporate new technology into their daily workflow is a
challenge of the INS.
 Even though INSs appear to work behind the scenes, INSs impact the health
and clinical outcomes of patients.
NI Roles

 Project manager

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 Consultant
 Educator
 Researcher
 Product developer
 Decision support or outcomes manager
 Advocate or policy developer
 Clinical analyst or system specialist
 Entrepreneur
Core Responsibilities of Informaticists

 Knowledge building and dissemination

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 Promoting interoperability
 Supporting safe patient centered care
 Ensuring inter-professional workflow and communications
 Participating in key health policy decisions
(Nursing Informatics Working Group of the American Medical Informatics Association (2020))
Specialty Education and Certification (1 of 2)

 The informatics nurse has a BSN and additional knowledge and expertise in the
informatics field.

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 The INS holds an advanced degree or a post-master’s certificate and is
prepared to assume roles requiring this advanced knowledge.
Specialty Education and Certification (2 of 2)

 Nurses who specialize in NI have two certifications available to them.

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 Certification through the ANCC exam. The applicant must be a licensed RN with at
least 2 years of recent experience, have a BS or BSN, and have completed 30
contact hours of continuing education in informatics.

 Certification through the HIMSS exam. Candidates who successfully pass this
exam carry the designation of certified professional in healthcare information and
management systems (CPHIMS).
Certificates and Certification

 A certificate program
 Educational or training program

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 Specified learning objectives
 Outcome achievement measures

 Certification
 Testing program to assess knowledge, skills, and abilities
 Nationally recognized
 Typically includes practice hours requirements
NI Competencies

 A challenge in health care is the vast differences in computer literacy and

information management skills that healthcare workers possess.

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 The competencies for NI practice Levels 1 through 4 have been further refined
with two self-assessment tools developed.
Competency Defined

 It is critical that nurses and INSs can demonstrate competence.

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 Hunter et al. (2013) define competency as a concept applicable to multiple
situations.
 At its most basic, competency denotes having the knowledge, skills, and ability to
perform or do a specific task, act, or job.
 Competency can refer to adequate or expert performance.
Rewards of NI Practice

 The INS is instrumental in designing EHRs.

 Designs tools that allow healthcare workers to access patient information more

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efficiently, which is satisfying
 Change is a factor that an INS deals with on a daily basis.
 The INS participates in informatics organizations that allow INSs to network and
share experiences with one another.
NI Organizations and Journals

 The Healthcare Information and Management Systems Society (HIMSS) was

launched in 1961.

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 Offers many advantages for nurses, such as access to numerous weekly and
monthly publications, and two scholarly journals, the Journal of Healthcare
Information Management and the Online Journal of Nursing Informatics (OJNI)
 The American Medical Informatics Association (AMIA) was founded in 1990
when three health informatics associations merged.
 The American Nursing Informatics Association (ANIA) was established in 1992.
 The Alliance of Nursing Informatics (ANI) is a coalition of NI groups that
represents more than 3,000 nurses and 20 distinct NI groups in the United
States.
Job Responsibilities of the INS

 Systems implementation

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 System optimization/utilization
 Systems development
 Clinical analytics
 Quality initiatives and reporting
 Informatics education, liaison/communicator
 Regulatory initiatives
 Project management
 Change control/ management
The INS and Interprofessional Teams

 Lead interprofessional team collaboration efforts

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 Reach across professional boundaries and surface and support the unique
contributions of professionals to patient care
 Ensure that IT tools are used effectively
 Promote and support interprofessional collaboration
Summary

 NI is a specialty that integrates nursing science, computer science, and

information science to manage and communicate data, information, knowledge,

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and wisdom in nursing practice.
 Nurses have been actively involved in this field since computers were
introduced to health care.
 With the advent of EHRs, it became apparent that nursing needed to develop
its own terminology and NI has been instrumental in this process.
Thought-Provoking Questions

 A hospital is seeking to update its EHR. It has been suggested that an INS be
hired. This position does not involve direct patient care and the administration is

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struggling to justify the position. How can this position be justified?

 It is important that all nurses be informatics competent at all levels. At which

levels should the INS be able to exhibit competency? Provide several examples
of the knowledge and skills that an INS might demonstrate.

 How does nursing move from measuring the tasks completed to measuring the
final outcome of the patient? How can the INS help us reach this goal?