Click to edit Master subtitle style

Nursing Informatics

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

11

Overvie w

Nurses are becoming computer literate and the nursing profession is implementing practice students for its clinical care and data standards for its nursing information technology systems.

NI represents the transitionT of 22 Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information

What is Informatics?

Informatics is the science and art of turning data into information (Bemmel and Musen, 1997). is an adaptation of the French term informatique, which refers to the computer

It

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

33

What is Nursing Informatics?

It is a 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, information and knowledge to support patients, nurses, and other providers in Sonny C. Chiu, MA.Ed. CNU-Information T 44 their decision-making Compiled & Designed by:

Computer & Networks in NUR

Computer in nursing are used to manage information in patient care, monitor the quality care, and evaluate the outcomes of care. are now used for communicating (sending/receiving) data and messages via the Internet, accessing resources, and interacting with the patients on the World Wide World (www). 55
Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Networks

Click to edit Master subtitle style

The Evolution of Informatics & other Definitions

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

66

How did it begin?

Computer Technology emerged in nursing in response to the changing and developing technologies in the health care industry and in nursing practice. Nursing Informatics TIMES Period: evolved in SIX

i. Prior to the 1960s 1980s

iv. The
77

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Prior to the 1960s

Starting

in the early 50s, and as the computer industry grew, the use of computer in the health care industry also grew. few experts who attempted to adapt computer to health care and nursing. the image of nursing improved, 88

Only

As

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Prior to the 1960s

Computers

were initially used in the health care facilities for basic business office functions. early computers used punch cards to store data and card readers to read computer programs, sort and prepare data for processing.
99

The

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The 1960s
During

the early 60s, the use of computer technology in health care began to be questioned. Why computers? and What should be computerized? were conducted to determine the effective utilization of the computer technology in health care industry and to identify the areas of nursing that needs to be automated. 10
10

Studies

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The 1960s
Hospital

information systems (HIS) were developed primarily to process financial transactions and serve as billing and accounting systems. systems were beginning to enter the health care field and market software applications for various hospital function

Vendor

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

11 11

The 1970s
Nurses

began to recognize the value of computer for their profession and see computers potential in improving the documentation of nursing practices, the quality patient care, and the repetitive aspects of managing patient care.

Giant

steps were taken during this decade in both NURSING & 12 Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T COMPUTER Technology. 12

The 1970s
Several Many

mainframe HISs designed and developed.

were

of the early HISs were developed and funded by the contractor or grants from federal agencies (National Center for Health Service Research, 1980)

Several

states and large community health agencies developed and/or contracted for their own computer13 Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T based management information 13

The 1980s
During

this decade, the field of informatics emerged in the health care industry and nursing. NI became an accepted specialty and many nursing experts entered the field. Technology challenged creative professionals and the use of computers in nursing became revolutionary. Many mainframe HISs emerged with
14 14

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The 1980s
Discharge

planning systems were developed and used as referrals to community health care facilities in the continuum care. emerged in this period, making more accessible, affordable, and usable by nurses and other health care providers.
15 15

Microcomputers/PCs

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The 1990s
In

the early 1990s, computer technology became an integral part of health care servicing, nursing practice and the nursing profession. and legislation were adopted promoting computer technology in health care including nursing.

Policies

16 In 1992, by: Sonny C. Chiu, MA.Ed. CNU-Information Tthe Compiled & Designed NI was approved by 16

The 1990s
This

period brought the smaller and faster computers-laptops and notebooks- to the beside and all of the point-of-care settings. and local are network were developed for hospital units, wide area networks were developed for linking care health care facilities, an the 17
17

Workstations

(LANs) nursing (WANs) across

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Post-2000
Clinical

Information Systems became individualized in the electronic patient record (EPR) or electronic health record Technologies continued to advance with mobile technology such as with wireless tablet computer, personal digital assistants (PDAs), and cellular phones.
18 18

Information

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Post-2000
Home

health care has also increasingly partnered with information technology for the provision of patient care. is increasing in popularity and providing patient care in an efficient and expeditious fashion.

Telenursing,

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

19 19

Click to edit Master subtitle style

Other Definitions of Informatics

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

20 20

Medical informatics
May

be used to refer to the application of information science and technology to acquire, process, organize, interpret, store, use, and communicate medical data in all of it forms in medical education, practice and research, patient care and health management or more broadly to the application of informatics to all of the health care disciplines as well as the 21 Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T practice of medicine. 21

Health Informatics
The

application of computer and information science in all basic and applied biomedical sciences to facilitate the acquisition, processing, interpretation, optimal use, and communication of health related data. The focus is the patient and the process of care, and the goal is to enhance the quality and efficiency of care provided.
22 22

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Bioinformatics
The

application of computer and information technology to the management of biological information including the development of databases and algorithms to facilitate research.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

23 23

Biomedical Informatics
The

science underlying the acquisition, maintenance, retrieval, and application of biomedical knowledge and information to improve patient care, medical education, and health sciences research.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

24 24

Consumer Health Informatics

Branch

of medical informatics that analyzes consumer needs for information and methods for making information accessible and implements those methods modeling consumer preferences into medical information systems. (Eysenback 2000)

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

25 25

Dental informatics
Application

of computer and information sciences to improve dental practice, research, education, and management. (Schleyer and Spallek 2001)

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

26 26

Clinical informatics
Multidisciplinary

field that focuses upon the enhancement of clinical information management at the point of health care through improvement of information processes, implementation of clinical information systems, and the use and evaluation of clinical decision support (CDS) tools as a means to improve the effectiveness, quality, and value of services 27 rendered. Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T 27

Public Health Informatics

Application

of information and computer science and technology to public health practice, research, and learning.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

28 28

Click to edit Master subtitle style

Informatics in the Health Care Professions

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

29 29

Data
A

collection of numbers, characters, or facts that are gathered according to some perceived need for analysis and possibly action at a larger point in time. (Anderson, 1992)

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

30 30

Information
A

collection of data that are arranged in a logical order.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

31 31

Knowledge
The

synthesis of information derived from several sources to produce a single concept or idea. It is based on a logical process of analysis and provides order to thoughts and ideas and decreases uncertainty (Ayer 1966; Englehardt 1980)

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

32 32

Information Technology
A

general term used to refer to the management and processing of information, generally with the assistance of computers.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

33 33

Roles of a Nurse
Data

gatherer user user builder

Information Knowledge Knowledge

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

34 34

Nursing Informatics
Broadly

defined as the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education and research.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

35 35

Categories (ANA)
Definitions

with an information technology focus oriented definitions that focus on roles

Conceptually Definitions

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

36 36

Nursing Informatics Model

Nursing Science Cogniti ve Scienc e
Informatio n Science

Informatics

Comput er Scienc e
37 37

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Click to edit Master subtitle style

Four levels of informatics competencies for nurses

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

38 38

The Beginning Nurse

Has

fundamental information management skills use information systems

Can

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

39 39

The Experienced Nurse

Is

proficient in his/her area of specialization and highly skilled in the use of IT and computers to support that area of practice. the relationship between data elements and makes judgments based on observed trends and patterns.

Sees

information systems and works with the informatics specialist to 40 Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T enact improvements in information 40

Uses

The Informatics Nurse Specialist

Has

advanced preparation in information management. on informatics applications to support all areas of nursing practice. skills in critical thinking, data management and processing, decision making, and system development and computer skills.
41 41

Focuses

Uses

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The Innovator Nurse

Is

educationally prepared to conduct informatics research and generate informatics theory. the vision of what is possible and has the ability to make things happen.

Holds

creative in developing solutions, possessing a sophisticated level of understanding and skills in information management and Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T computer technology.

Is

42 42

Click to edit Master subtitle style

Applications of Nursing Informatics

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

43 43

Nursing Practice
Work

lists to remind staff of planned nursing interventions client documentation including discharge instructions and medication information devices that record vital signs and other measurements directly into the client record
44 44

Computer-generated

Monitoring

Computer-generated

nursing care T Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information

Nursing Practice
Automatic

billing for supplies or procedures with nursing documentation and prompts that appear during documentation to ensure comprehensive charting access to computer-archived patient data from previous encounters drug information
45 45

Reminders

Quick

Online

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Nursing Administration
Automated Online

staff scheduling

bidding for unfilled shifts

Electronic Cost

mail for improved communication analysis and finding trends for budget purposes assurance and outcome analysis
46 46

Quality Patient

tracking and placement for Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T case management

Nursing Education
Online

course registration and scheduling student tracking, and grade management instruction delivery and support for Webbased education access to library and internet resources
47 47

Computerized

Computer-assisted Course

Remote

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Nursing Research
Computerized The The

literature searching

adoption of standardized language related to nursing terms ability to find trends in aggregate data, which is data derived from large population groups of the internet for obtaining data collection tolls and conducting research Collaborate with other nurse
48 48

Use

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Current Status of Health Care Delivery

Patient

safety and medication errors shortage

Nursing

demands for costeffective, quality care based on best practices, managed care, economic survival, and pressure to implement IT solutions that include computerized physician order entry with decision support, bar code medication administration, Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T electronic or computerized patient 49 49

Consumer

Benefits of Nursing Informatics for Other Health Care Professionals

Click to edit Master subtitle style

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

50 50

Specific Benefits of Electronic Medical Records

Improved Error

access to information

reduction and improved communication redundancy of data entry

Decreased

Convenience Decreased Increased

time spent in medication administration and documentation time for client care
51 51

of data collection for T Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information

Facilitation

Specific Benefits of Electronic Medical Records

Improved Improved Improved Improved

quality of documentation

compliance with regulatory requirements record security quality of care and patient satisfaction administrative costs for location and maintenance of client records
52 52

Decreased

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

The Role of the Informatics Nurs

Theory

development of information needs of computer systems

Analysis

Selection Design

of computer systems and customizations of computer systems users of computer systems of users on information
53 53

Testing

Training

Education

policies by: Sonny C. Chiu, MA.Ed. CNU-Information T Compiled & Designed

The Role of the Informatics Nurs

Ongoing

maintenance and enhancements of computer technologies that can benefit nursing with regulatory requirements for information handling
54 54

Identification

Compliance

management CNU-Information T Compiled & Designed by: Sonny C. Chiu, MA.Ed.

Project

Click to edit Master subtitle style

The Future of Nursing Informatics

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

55 55

Richards (2001)
The

new generation of nurses will bring their familiarity with technology and information literacy to exert their power and influence in health care. The new generation of nurses will understand and exercise their power to transform research into practice. They will also exhibit their creativity, innovation, and practical know-how in the way they use IT.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

56 56

Hardware, Software and the Roles of Support Personnel

Click to edit Master subtitle style

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

57 57

Definitions
Computer Hardware Software Input

devices Processing Unit Memory (ROM) storage devices

58 58

Central

Read-Only Random

Access Memory (RAM)

Secondary

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Categories of Computers
Supercomputers Mainframe

computers (PCs)

Minicomputers Microcomputers Laptop Tablet PDAs

or notebook computers

computers

and other handheld devices

59 59

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Peripheral Hardware Items

Monitors

External

Keyboards Terminals Mouse

modems
Printers Scanners Digital

and other pointing devices

Secondary

and web cameras (webcams)

60 60

Multifunction storage devices devices Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Networks
Local

Area Networks Area Network Area Network

Metropolitan Wide Thin

client technology

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

61 61

Equipment Selection Criteria

The The

types of applications required

program execution time and computer capacity needed to process jobs number of workers who need computer access at any one time capacity options considerations
62 62

The

Storage Backup Budget

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

User Needs
Ergonomics

the study and design of a work environment that maximizes productivity by reducing operator fatigue and discomfort. Stress Injuries (RSIs) or Repetitive Motion Injuries result from using the same muscle groups over and over again without rest (carpal tunnel syndrome)
63 63

Repetitive

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Measures to Ensure Good Ergonomics When Using a Computer-Work Station

Determine

how a workstation will be

used.
Determine Configure Select

the length of time the use will be at the workstation. work areas for specific types of equipment. sturdy surfaces or furniture with sufficient workspace.
64 64

Provide

chairs with good lumbar T Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information

Measures to Ensure Good Ergonomics When Using a Computer-Work Station

Adjust

screen resolution and font size as needed. look away from the monitor to distant objects. screen glare frequent breaks noisy locations.

Periodically Minimize Take

Avoid Place

the workstation in a wellventilated area.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

65 65

Examples of Ergonomic Devices

Glare

Filter Tilt Keyboard Holder Mouse

Negative

Document Ergonomic Lumbar Wrist

Support Braces/Gloves Keyboards

66 66

Rests

Support

Ergonomic

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Mobile & Wireless Computing

Mobile

Computing devices that can be carried or wheeled from place to place. May not have the capability to receive and transmit information while mobile. Devices are equipped with a special card enabling it to broadcast and receive radio or cellular signals that reach the network via access points.
67 67

Wireless

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Advantages
Both Cost Improved More Error

technologies bring computing to the bedside data collection

efficient work processes reduction

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

68 68

Concerns
Theft

and loss to data security life limitations

Threats Battery Data

loss

Memory Limited Dead

ability to display and see information zones

69 Lack of a means to readily exchange 69

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

Software
Operating

Systems Systems

Application Utility

Programs

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

70 70

Click to edit Master subtitle style

Roles of Support Personnel

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

71 71

Super user
Additional

computer experience over the average employee and serves as a local resource person.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

72 72

Call Desk and Help Desk Personnel

First

line of user support within an organization.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

73 73

Microcomputer or PC Specialist
Provides

users with PC information and training, enabling them to perform routine tasks.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

74 74

Analyst
Health

care information system analysts are responsible for a wide range of activities related to the successful automation of information management.

Interview

staff, determine user needs, write specifications for software performance, participate in some computer programming and debugging, implement new automated functions, by: Sonny C. Chiu, MA.Ed. program 75 Compiled & Designedand document CNU-Information T
75

Clinical Liason
Clinicians

who represent the interests and need of the users and work with the information system team to address these issues during system design and implementation.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

76 76

Programmer
Write

the code, or instructions, that tell the computer what to do. Often lack a clinical background.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

77 77

Network Administrator
Responsible

for planning, management, and expansion of networks.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

78 78

Trainer
Responsible

for educating clinical users in one for more applications and may also be required to define and monitor user competences.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

79 79

Security Officers
Responsible

for ensuring that measures exist to protect information privacy.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

80 80

Chief Information Officer

Should

have a broad view of the needs of the institution and the design, implementation, and evaluation of information systems. Responsibilities include strategic planning, policy development, budgeting, information security, recruitment, and retention of information services staff, and overall management of the enterprises information systems.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

81 81

Webmaster
Responsible

for the design, maintenance, and security of materials placed on the Internet, intranet, and/or extranet.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

82 82

Chief Privacy Officer

Protects

the personal health information of patients. This includes paper and electronic information.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

83 83

Chief E-health Officer

Exists

in organizations that are expanding their use of the Internet beyond Web sites that provide information to a strategy that includes interactive services.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

84 84

Compliance Officer
Designated

to ensure that state and federal regulations and accrediting requirements are met both via paper and automated records and systems.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

85 85

Disaster Planning & Recovery Officer

Designated

to ensure that plans are up-to-date and that all contingencies have been covered. Coordinates and update plans for natural and man-made disasters, including acts of terrorisms.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

86 86

Interface Engineer
Ensures

that information is exchanged between disparate systems and isolates and corrects problems behind the scenes invisible to the users of the individual systems.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T

87 87