Nursing informatics

Nursing Informatics

Winfield Constantino Tuayon RN MAN

“A specialty that integrates nursing science, computer science and information science to manage and

communicate data, information, and knowledge in nursing practice … to support patients, nurses, and other providers in their decision-making in all roles

and settings.”

- American Nurses Association, 2008

Why do we need to study Nursing Informatics ?

• Information is doubling every 5 years , if not tripling in quality and quantity• INFORMATION is POWER• Technology facilitates the creative process in nurses, affording amazing vehicles for, PATIENT EDUCATION, TEACHING and LEARNING •Provides health promotion and prevention in a Global Scene.

Nursing Practice will be revolutionized and we will truly be a

profession of nurses with our own classification systems, bibliographic

systems, and payment systems.

What is Informatics ?

• Combination of the terms information and automatic/ automation which means automatic information processing.

•A science that combines the domain science, computer science, information science and cognitive science.

Origins of Nursing Information System 1977 – the first Nursing Information System Conference was held in the United States

Here nurses adapts computer processes to enhance client care, education, administration and management, and nursing research

October 1995 – the first ANA certification examination in Nursing Informatics was given.

This creates the Nurse Informaticists They are responsible for interfacing between the client care and information technology departments and assisting with the development, implementation and evaluation of initiatives in clinical information system.

Origins of Nursing Information System 1999 – a study was form to identify International Standards for health information and their adaptability in the Philippines referred to as “Standards of Health Information in the Philippines , 1999 ver. (SHIP99).

2003 - Master of Science in Health Informatics was proposed to be offered by UP-Manila College of Medicine (major in medical informatics) and the College of Arts and Science (major in bioinformatics) and was later approved to be offered starting academic year 2005-2006.

Origins of Nursing Information System 2006 – creation of TIGER (Technology Informatics Guiding Educational Reform )- Created to identify knowledge/information management best practices and effective technology capabilities of nurses.

Origins of Nursing Information System 2008 – Nursing Informatics course in the undergraduate curriculum was defined by the Commission on Higher Education (CHED) Memorandum Order 5 Series of 2008, later revised and included as Health Informatics course in CHED Memorandum Order 14 Series of 2009, and first implemented in the summer of 2010.

Origins of Nursing Information System 2009 - Mr. Kristian R. Sumabat and Ms. Mia Alcantara-Santiago, both nurses and graduate students of Master of Science in Health Informatics at the University of the Philippines, Manila began drafting plans to create a nursing informatics organization2010 - they began recruiting other nursing informatics specialists and practitioners to organize a group which later became as the Philippine Nursing Informatics ,a sub-specialty organization of PNA for nursing informatics.

Framework of Nursing Informatics

Data – discrete entities that are described objectively without interpretation

Information – as data, however is interpreted, organized or structured

Knowledge – as information that has been synthesized so that interrelationships are identified and formalized

… this results to DECISIONS that guides practice…

Framework of Nursing Informatics

Computer System A network of computers, users, programs and procedures in an organization – assists the health care team with decision making and communication.

Two (2) most common types of Computer System :

(1)Management Information System

(2)Hospital Information System

Management Information System (MIS)

Designed to facilitate the structure and application of data used to manage an organization or department.

- Provides analyses used for strategic planning, decision making and evaluation of management activities.

Hospital Information System (HIS)

An MIS that focus on the types of data needed to manage client care activities and health care organization.

- Provides people with the data they need to determine appropriate actions and control them.

Scope of Nursing Informatics

P Practice

E Education

R Research

A Administration

Nursing Informatics & Practice

Nurses are expected to have knowledge about the benefits and limitations of technology for communication and decision making, and attitudes needed to value technology and use informatics to both support and protect clients. (Cronenwett et al. 2007)

Nursing Informatics & Practice DOCUMENTATION AND MEDICAL RECORD

KEEPING

Bedside Data Entry

These allows recording of client assessments, medication administration, progress notes, care plan updating, client acuity, and accrued charges.


KEEPING

Bedside Data Entry

The terminals can be fixed or handheld, and hardwired to the central system or wireless with the ability to transmit the data to distant sites.

POINT-OF-CARE / POINT-OF-SERVICE COMPUTER-terminal is near, but not necessarily at, the client.


KEEPING

Computer-Based Client RecordsElectronic Medical Records (EMR) / Computer Based Patient Records (CPRs)

- permits electronic client data entry and retrieval by caregivers, administrators, accreditors, and other persons who require the data.


KEEPING

Computer-Based Client RecordsElectronic Medical Records (EMR) / Computer Based Patient Records (CPRs)’s way of improving healthcare:(1) Constant availability of client health information across the

lifespan (2) Ability to monitor quality(3) Access to stored data(4) Ability of the clients to share in knowledge and activities

influencing their own health

Nurse Informaticist

- an expert who combines computer, information, and nursing sciences

- Serves as a developer of policies and procedures that promote effective and secure use of computerized records by nurses and other health care professionals


KEEPING

Computer-Based Client RecordsPersonal Health Record (PHR)

- an electronic document that contains the client’s medical, personal, and health information but is controlled by the client, rather than the health care provider.


KEEPING

Computer-Based Client RecordsPersonal Health Record (PHR)

- an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed , shared , and controlled by the individual.


KEEPING

Clinical Decision Support System

- are electronic forms of charts, templates, algorithms , and the likes, which incorporate evidence from the literature into a particular client in order to guide care planning . - some are simple alarms that appear when medical orders conflict with another aspect of client’s situation ( allergies, contraindications)


KEEPING

Tracking Client Status

- this is when the nurse can retrieve an d display a client’s physiological parameters across time. Furthermore , Standardized Nursing care plans, care maps, critical pathways can be stored in the computer via EMR.

Nursing Informatics & Practice Electronic Access to Client Data

Client Monitoring and Computerized Diagnostics

- these devices, with their minute but powerful computer chips, makes it possible to extend the nurses’ observations and provide valid and reliable data

Nursing Informatics & Practice Electronic Access to Client Data

Telemedicine / Telehealth

- uses technology to transmit electronic data about clients to persons at distant locations.

Nursing Informatics & Practice Practice Management

- Terminals used to order supplies, tests, meals and services from other departments. - Computers used extensively for scheduling (client appointment and staff scheduling requests) - For Insurance keeping so that billing can be accurate.

Nursing Informatics & Practice Community and Home Health

-A computer placed in a high-risk client’s or family’s home allows them to access information on a variety of topics, search Internet, or e-mail a health care provider with questions and concern. -Home alert systems that allow the client to signal the base station in an emergency situation. -CHN uses notebook computer to transmit data to the main office.

Nursing Informatics & Practice Case Management

-Tracking of a group of clients – the caseload.- keeps abreast of the latest regulations affecting eligibility for health care benefits, the reporting requirements of the payer’s agencies, the detailed facts about the variety of service providers that the client needs to access.

Nursing Informatics & Education


Teaching and Learning

Computer enhances both students and faculties in 4 ways:

(1)Literature(2)Computer assisted instruction(3)Classroom technologies(4)Distance learning strategies



Literature Access and Retrieval

-Continuous updated cumulative indexes of related materials can be searched electronically in a fraction of the time. - Once a list of search matches is displayed on the computer screen, users can select all of certain citations and etheir print them or store.



Computer assisted instruction (CAI)

- Software programs that cover topics from drug dosage calculations to ethical decision making are classified according to the format: tutorial, drill and practice, simulation , or testing.




- Diagrams, graphics, animations, video, and audio via CD-ROMs or via the internet.




- Allow almost instant access to any section of the program and can be designed to branch to different sections depending on user’s responses.



Classroom Technology

- Electrical outlets for students to plug in laptops and wirings (Wi Fi) for network and internet access.




- “smart classrooms” with projectors that display the content of computer screens and document cameras that display objects and print materials for the entire classroom.




- “clickers” use of audience response systems and class-capture systems that record and post lectures and visuals to the Internet.




-Tools ranging from systems that use computers and small devices to provide skills practice (task trainers)

-High fidelity Human Patient Simulators with the ability to breathe , speak, and display digital readouts that reflect the impact of nursing interventions.



Distance Learning

-Educational opportunities delivered under situations in which the teacher and the learner are not physically in the same place at the same time. - asynchronous – when the persons involved are not interacting at the same time. -Synchronous – when teachers and students are communicating simultaneously



Distance Learning

-Faculty can post syllabi, handouts, assignments, and examination in individual course shells, and students can submit papers and hold discussion online



Distance Learning

-Faculty and students can create avatars – virtual self to navigate through simulated worlds and communicate using audio-visual lectures, discussion and posters.



Testing

- Computers are ideal for conducting types of learning evaluation-Large banks of potential items can be written and the computer generates different exams for each student depending on the selection criteria designated by the faculty



Testing

- the computer determines if the applicant passed the examination by using a scoring algorithm that ensures all required competencies have been evaluated fairly



Student and Course Record Management

- Computers are useful for maintaining results of students’ grade or attendance using spreadsheets. -Programs can calculate percentages , sort student scores in order, and print results for the students and the faculty.



Student and Course Record Management

- data warehousing – the accumulation of large amounts of data that are stored over time and can be examined for output in different types of reports (charts & tables)

Nursing Informatics & Research

Nursing Informatics & Research PROBLEM IDENTIFICATION

Locating current literature about the problem and related concept, as unknown to the researcher, a solution to the problem has already been found and reported.

Nursing Informatics & Research Literature Review

-Utilization of online search and CD-ROM Bibliographic data base. -Software programs that facilitate searches contain thesaurus thus, appropriate terms can be searched. -Closely related topic can be searched-The increase in availability of full text journal articles online has made the electronic literature search process even more productive.

Nursing Informatics & Research Research Design

-Searching of literature for the instruments that have already been established or to design and instruments that need to be developed for the particular study.

Nursing Informatics & Research Data Collection and Analysis

-Variables should be recognized and manipulate (coding the data) by the computer for analysis. e.g. NVivo and Ethnograph-Variables if coded, can be calculate descriptive and analytic statistics. e.g. SPSS(Statistical Package for Social Sciences), SAS (Statistical Analysis System), -- this will perform analysis and present it in tables, chart or lists.

Nursing Informatics & Research Research Dissemination

-Computers speed completion of the research project and the availability of the findings to the public.

Nursing Informatics & Nursing Administration

Nursing Informatics & Nursing Administration Human Resources

-Maintains database: Demographic data, Salary, and Performance Appraisals

-Database can be use to communicate with the employee, examine staffing patterns, and create budget projections.

Nursing Informatics & Nursing Administration Medical Records Management

-It is expensive to keep records, but it is more expensive not to be able to access what is in them.

-Allows client records to be searched for trends

Nursing Informatics & Nursing Administration Facilities Management

-A/Cs , Ventilations and Alarm systems-Scanners (ID), Bar codes, -Inventories

Nursing Informatics & Nursing Administration Budget and Finance

-Computerized billing vs Handwritten-Nurses can directly bill

Nursing Informatics & Nursing Administration Quality Assurance and Utilization Review

- Facilitates the accumulation and analysis of data for individual groups or client, when standards, pathway and key indicators, and other vital data have been identified and described. - Utilization review consists of examining trends and proposing advantageous disposition of resources.

Nursing Informatics & Nursing Administration Accreditation

-To monitor quality indicators, so as to reduce the difficulty of time involved in the accreditation proces

Thank you..

Date post:	24-Jan-2017
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