NURSING INFORMATICS IN CANADA

Registered nurses need to be able to demonstrate their unique contribution to

the health of Canadians within Canada's rapidly evolving health care system.
Basic, essential nursing information is required by nurses, employers,
researchers,
educators, policy makers, and clients so that informed decisions can be made
about nursing's role in the changing health care system," The National
Nursing Informatics Project.
In 1998, the Canadian Nurses Association spearheaded another initiative, the
National Nursing Informatics Project, to begin to develop a national consensus
on definition, competencies, and educational strategies and priorities in
nursing informatics development.
"In 1998 a national steering committee was formed to address Nursing
Informatics issues and develop strategies to ensure that Registered Nurses
have the competencies required to successfully carry out the responsibilities of
their practice - whether that be clinical, administrative, educational or
research.
The committee members of National Nursing Informatics Projects
1. Canadian Association of University Schools of Nursing
2. Canadian Nurses Association,
3. Registered Nurses Association of British Columbia
4. Academy of Canadian Executive Nurses
5. COACH Nursing Informatics Special Interest Group.
Each participating organization appointed a nurse expert in Nursing
Informatics to a five-member working group to develop and initiate a plan to:
1. develop consensus on a definition of Nursing Informatics for Canada;
2. recommend Nursing Informatics competencies for entry level nurses and
specialists, managers, educators, and researchers;
3. identify curriculum implications and strategies for both basic and continuing
nursing education
4. determine priorities for implementing national nursing informatics
education strategies.

In 2002, an updated version Privacy and Confidentiality of Health Information

at CIHI: Principles and policies for the protection of health information In
March 2000, the CIHI published an updated version of the Roadmap Initiative,
a national vision and four-year action plan to modernize Canada's health
information system The CIHI also provide a comprehensive Good sourcing
Statistics website related to Canadian health and health care, society, the
environment and National populations. Dozens of other reports are available
on the CIHI website, related to population health, health indicators, health
workforce, issues in health and health care institutions.
Another national organization, the Canadian Organization for the
Advancement of Computers in Health or COACH, founded in 1975 actively
initiated professional protocols for using computer systems in Canadian health
care.

One important document, Guidelines to Promote Confidentiality and Security

of Automated Health-related Information (1979), In 2001, COACH, as Canada's
Health Informatics Association, launched the Patron Program. As an individual
member based organization, COACH promotes understanding and effective
utilization of information and information technologies within the Canadian
Healthcare industry through education, information, networking and
communication. Today, COACH is a leading organization with an evolving
membership. It is in the forefront of the Canadian Healthcare information
resource and technology field by working cooperatively with health
institutions, professions, associations, consultants, vendors of information
technology and applications, government and regulatory organizations in the
pursuit of its mandate. in February 1999 the Canadian Federal government
published the timely document, Strengthening Health Care for Canadians,
outlining new initiatives and funding to promote health care technology and
informatics initiatives.
Various nursing programs are beginning to offer courses and content in
Nursing Informatics. some programs integrate informatics into individual
courses, which is the model we have adopted in the BSN Nursing Program
slowly but steadily, other colleges and universities are expanding their
curricula to include Nursing Informatics at both the undergraduate and
graduate levels. As more nurses become computer literate, and become aware
of the potential of technology to support nursing documentation, decisions,
and professionalism, Nursing Informatics can become a strong and integral
part of Canadian nursing science. With this goal in mind, The BSN Nursing
Program has adopted Nursing Informatics as an integral component of the
curriculum In 2001, a new group, the Canadian Nursing Informatics Association
(CNIA) received emerging group status from the CNA and affiliate status in
2003. The CNIA now has full associate status with the CNA.
The CNIA conducted a study in 2002 - 2003 on the Informatics Educational
Needs of Canadian Nurses, funded by the Office of Health and the Information
Highway, Health Canada or OHIH called Educating Tomorrow's Nurses:
Where's Nursing Informatics? The intent of the study was to describe the
current state of informatics education opportunities currently available to
students of nursing across the country, the level of preparedness of nursing
faculty to deliver these offerings, information and communication technology
infrastructure and support for faculty in delivering these offerings, and
opportunities to enhance nursing curricula, faculty preparedness, and ICT
infrastructure and support in schools of nursing across Canada. Nursing
Informatics at Kwantlen Polytechnic University wantlen Polytechnic University
offers the BSN and BSN Post Baccalaureate Nursing Programs which integrate
both theory and practice of Nursing Informatics across the program in BC,
Canada.
The faculty of the BSN Nursing Programs fully support that Nursing Informatics
is central to nursing in the various domains of practice. Since 1996, Kwantlen
Polytechnic University faculty have integrated Nursing Informatics into all
semesters of the program. Learning activities which include: . a Cognitive, ("to
know" or epistemological), an Interactive, ("to do" or ontological) as well as a
Reflective, ("to be" or phenomenological) component
 Nursing Informatics in Asia,
South Korea
Health Informatics in South Korea has growth considerably in recent years
professional outreach activities.
In the contrast, computers were not used in nursing education and research in
1993 and NI was not taught in universities until 1994 In 1993 ,The Nursing
Informatics, special interest group was organized in the KOSMI, since the
nursing informatics group has held its own session at the biannual conferences
of the KOSMI. Nursing has been highly visible in the KOSMI by the presentation
and publishing of papers on the used of computers in nursing of these
conferences and in the journal of the KOSMI.
According to the report published by the Korea Health Industry Development
Institute in 2000,100% of teaching hospitals, and 75% of private clinics now
have hospital information systems ( Korea Health Industry Development
Institute,2000). Such a high implementation rate is believed to have been
initially driven by financial factors associated with medical insurance claims,
with the focus subsequently shifting to all areas of patient care when clinicians
began to use computers in their practice. A recent study shows that all of the
teaching hospitals and about 40% of general hospitals in Korea are using order
Communication systems (Kwak 2000), which enable physicians to
communicate with other departments for practiced -related requisitions and
the retrieval of data. In addition, about 95% of teaching hospitals and 20% of
general hospitals are equipped with pictures archiving and communication
system (PACS's). There has been a great deal of interests among healthcare
organizations in acquiring the system since the government announced high
reimbursement rates for diagnostic radiology examinations using PACS in 2000,
and PACS are now one of the most common information technology systems in
South Korea hospitals. Hospitals in South Korea are now beginning to
implement paperless electronic medical record systems.
The use of computers in clinical nursing practice in Korea began first in
medium-sized hospitals. This hospital initially used computers mainly for
administration and billing, as did most hospitals in other countries, but later a
patient-care component was added. This system allowed physician to enter
medical orders directly into the computers, and major ancillary department
could receive requisitions and enter test results. The nurses work list could be
viewed on screen or printed so that the nurses did not need to copy
medication schedules or care activities into the cardex or write paper
messages.
A home healthcare system for community-based clinical practiced was
developed by the Home Healthcare Team at the College of Nursing, Seoul
National University ( Park et al.,2000).Home healthcare nurses use laptop
computers to note and check medication and progress in electronic patient
records, and to communicate electronically with other home healthcare team
members.

South America brazil

In today’s healthcare environment, communication and information
technologies have made the delivery of nursing care more challenging, diverse,
and complex. Due to the economy, policies to protect consumers and users,
emerging diseases, workforce shortage, care delivery models, and
globalization, there are many considerable changes in the practice of nursing
informatics. As forecast by Hannah and Ball in the 3rd Edition of Where Caring
and Technology Meet, nurses have become primary users in information
technology, and nurses have also taken a leading role in the development,
implementation, and evaluation of healthcare systems.
The first initiatives in the informatics field began around 1975 in São Paulo
with the first Brazilian Symposium in computer applications in medical
hospitals. Early records related to nursing informatics date back to 1985, when
faculty of nursing from Federal University of Rio Grande do Sul (UFRGS)
presented their experience in the use of computers to teach nursing activities
in home care.2 Subsequently based on this interest in the contributions of
technology resources in the healthcare, the Brazilian Society of Health
Informatics was founded in 1986 when the First Congress in Health Informatics
was held in city of Campinas. In 1990, the third Congress of the Brazilian Health
Informatics Society was held in the city of Gramado, Rio Grande do Sul. At this
congress, a dedicated session for nursing informatics was organized by some of
the national pioneers in the field, including Beatriz Lara dos Santos and Lia
Funcke (UFRGS), Marli Theoto Rocha (Nursing School, University of São Paulo),
Evanise Arone (SENAC), and Heimar de Fatima Marin (Federal University of São
Paulo).
Currently, similar groups at universities across the country and several schools
of nursing have established nursing informatics as a discipline in the nursing
curriculum and have organized nursing informatics research groups. A
retrospective search was conducted in the electronic directory of the Brazilian
Research Council for Science and Technology (CNPq) of Brazil, between 1922
and 2008. This search revealed that there are 16 nursing informatics research
groups that have been established in Brazil. However, among the total number
of 323 research groups of all types included in this directory, approximately 28
groups (42%) had developed some type of study and research in ICT.
Since the early stages of nursing informatics development in Brazil, research,
education, and practices have developed considerably. Currently, it is
impossible to practice or to communicate without the support of some
technology resource. Great achievements have been reached by nurses across
the country in incorporating technology in the daily practice. Informatics
resources support practice-based knowledge generation as a significant
approach to measure effectiveness of nursing care.
Over the last years, since the pioneering initiatives in nursing informatics
began, several important accomplishments have been achieved to drive the
profession and developments in support of practice and education. It is clear,
however, that technology is the means but not the final product of
accomplishing nursing care. Examples of specific remarks and concerns are
provided below from nursing informatics expert and users presentations at
symposiums and meetings:
 Nursing Informatics in Europe
In Europe, as in many countries worldwide, the main rational for implementing
a greater use of information technology (IT) in the healthcare sector is to
improve safety and quality, improve patient outcomes, and at the same time
try to reduce costs of healthcare. •Europe is a continent with over 750 million
inhabitants in about 50 countries with many different languages, culture, social
system, and other living condition. This makes obvious that it is not possible to
provide the entire picture of nursing informatics in the area.

The main mission, in Europe, is to established a stable infrastructure quality,

facilitates the reduction of errors, and the delivery of evidence-based and cost-
effective care. Some core building blocks of this are electronic health record
(EHRs), nursing informatics education at all level, communication and
terminologies, and standards for technology, communication, and patient care
The Europe Commission (EC) is a driving force of healthcare informatics
development by funding projects that are all cross-cultural involving healthcare
professional users, educators, and administrators, always with three or more
countries participating.
Development of Common Terminologies for Nursing Practice In Europe
Some of the common factors that may have contributed to the development of
uniform terminologies for nursing in different European countries are:
Increasing cost constraints in the mostly publicly financed healthcare systems,
which have raised demands for cost-effective care and quality improvement.
Professionalization of nursing, the effort to make nursing visible and
aspirations for greater accountability have been additional influencing factors
In the Netherlands, a nursing information reference model (NIRM) has been
developed to accommodate both the information needs nurses at the clinical
level and for aggregating data at higher level. This model identifies a base
model of patient data; a second level of interpretation and decisions by the
nurse, including nursing diagnoses, interventions, and outcomes; a third level
of aggregated data on nursing diagnoses, interventions, and outcomes for
institutional purposes; and a fourth level of information aggregated for
international sharing.