Nursing informatics What is nursing informatics? Evolution of nursing informatics Role of the Nurse as knowledge worker Medical Informatics Consumer Informatics

2. Informatics,
What is it?

3. 1966 “Informatika”
Sackett and erdley (2002), a Russian Scientist in 1966 coined the term
informatika and defined it as “The discipline of science which investigates
the structures and properties (not specific content) of scientific
information..” (Collen as cited in sackettt & Elderly).
1970 “Informatique”
A frenchman, in the 1970’s, Francois Gremy is credited with coining the term
informatique medical, translated to medical informatics
It was defined as the informational technologies which are concerned with patient
care and the medical decision making process. Another definition stated that medical
informatics is the complex data processing by the computer to create new information.
1980 “Nursing Informatics”
The term “nursing informatics”, was probably used and defined by Scholes and
Barber in 1980 in their address to the MEDINFO conference that year in Tokyo.
Health- care informatics, howerver, is truly interdisciplinary. In its truest form it
focuses on the care of patient, not a specific discipline. Thus although there are
specific bodies of knowledge for ech health care profession, nursing, dentistry,
dietetics, pharmacy, medicine, etc.. They interface at the patient.

4. Evolution of
Nursing Informatics

5. Prior to the 1960’s
Few experts use computers
Nursing profession was undergoing major changes
Nursing practices and services was expanding in scope and complexity
Computers were initially used for office functions
Punch card and card readers
Teletypewriters and paper tapes.
Hospital information system (HIS)- billing and accounting dept

6. 1970’s
Nurses began to recognize the value of computers
Aside from HIS, computer-based management information system (MIS) was
developed by diff health agencies
Third party payers- Medicare patient services on billing and financial info.
1980’s
 NI became an accepted specialty and many nursing experts entered the field.
Computer-based patient record systems (CPRS)
Kardex, reporting of results, VS.
Discharge planning system was developed for community health care facilities in
the continuum care

7. 1990’s
IT and informatics were promoted in health care esp. Nursing field
1992- NI was approved by ANA as a new nursing specialty
Database for nursing vocabularies, taxonomies, classification
schemes were developed
Laptops, notebooks
Workstation and LAN were developed for hospital nursing units
Internet brought new cyberspace forming building blocks for
sophisticated IT
1995- e-mail, file transfer protocol (FTP), www protocols
High performance computing and communication (HPCC)

8. ANA Council on Computer Applications in Nursing 1992
“... a 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, and research : and to expand nursing knowledge. The purpose of
nursing informatics is to: analyze information requirements; designs,
implement and evaluate information systems and data structures that
support nursing: and identify and apply computer technologies for nursing.”
Nursing informatics: recognized by the ANA as a specialty in 1992
 Scope and standards of nursing informatics practice offers guidelines for the
specialist
 Certification examination offered by ANCC
 Formal education programs prepare the RN for entry into nursing informatics
specialty
Formal representing organizations include the American Mediacal informatics
Association (AMIA) and International Medical Informatics Association (MIA)
Defined research priorities seek a standard language
Differentiate practice focuses upon data informatiom and knowledge

9. Saba & Mc Cormick 1995
“It is concerned with the legitimate access to and use of data, information,
and knowledge to standardize documentation, improve communication, and
support decision-making process.”
“ The use of technology and/or a computer system to collect, store, process,
display, retrieve, and communicate timely data and information in and across
health care facilities that: Administer nursing services and resources, manage
the delivery of patient and nursing care, link research resources and findings to
nursing practice and apply educational resources to nursing education.

10. Post 2000
 Individualized electronic patient record (EPR) and EHR
Wireless tablet computers, personal digital assistants, cellphones, voice over
internet protocols were developed to enhance health care facilities.
Telenursing
Health Insurance Portability and accountability act of 1996 (HIPAA) was
enacted to streamline health care transactions
2004- protect the security, ensure privacy and confidentiality was
implemented.

11. Past Nursing Informatics
Nursing informatics was first defined as the use of computer
technology to support nursing, including clinical practice,
administration, education and research.
The first generation of nursing information systems was designed to speed
paperwork and communication. In general, the systems accomplished this by
transferring information to the computer, what nurses had done on paper
and by telephone. These systems replaced paper records, filing cabinets and
pneumatic tubes. Although this was helpful and effective in reducing the
time spent on documentation and communication it did not address many of
the fundamental issues for nurses’ use of data, information and knowledge
to guide effective care (Executive summary, 2004).

12. Until 1948, primary care remained in the home. With the development of Hill-Burton Act
of 1948, money was provided for the building of hospitals and promoted a catalyst for
change in healthcare. In the 1960’s, Medicare and Medicaid provided reimbursement for
services to many individual patients and the health insurance industry grew. This
provision of funding allowed many new innovations: new drugs, advanced surgical
procedures, new technologies and equipment, and sophisticated diagnostic procedures.
All of which led to the development of medical specialties, each treating a different part
of the patient and creating its own records for what patient (Thede, 2003).

13. Present Nursing Informatics
Although the history of nursing informatics extends only some twenty
years, the field is advancing rapidly as a scientific discipline and has
significant implications for patient care (Executive Summary, 2004).
As research in nursing informatics evolves, it has become apparent that
the issues are far more complex than reducing time spent on paper work.
The high-intensity generation, management, processing of data and
knowledge are integral components of nursing care. Informatics gives
nurses the means to carry out these aspects of care efficiently and
effectively to improve outcomes for patients.

14. Nursing informatics impacts nurses today. Today, evolving standards of
practice increase the nurse’s accountability. The malpractice crisis has
strengthened accountability and increased emphasis on complete and
detailed nursing documentation. Changes in reimbursement methods are
affecting nursing care delivery. Cost containment and consumerism place
additional pressures on not only the individual nurse but also the entire
nursing profession (Ball, et al. 2000).

15. Role of the Nurse as
knowledge worker

16. lHealth care settings are knowledge
intensive
lExponential growth in knowledge
lInformation technology supports
evidence -based practice through just-
in-time access to information
lNurses detect patterns to create new
knowledge

17. lData gatherer
Collects clinical data
lInformation user
Interprets clinical data and uses it to monitor pati, aids with
decisions.
lKnowledge user
Compares data to current knowledge
lKnowledge builder
Amassed data to show patterns that can be interpreted using
existing knowledge or used to create new knowledge.
Knowledge worker roles

18. lGood information management provides the right information at the
right time to the right people
lKnowledge management creates systems that enable organizations to
tap into the knowledge, experiences and creativity of their staff to
improve their performance
Information vs. Knowledge Management

19. Medical Informatics

20. The application of information
science and technology to
acquire, process, organize,
interpret, store, use and
communicate medical data in all
of its forms in medical education,
practice and research, patient
care, and health management.

22. Hebda (1998). Defines nursing
informatics as the use of
computers technology to support
nursing, including clinical practice,
administration, education and
research.

23. “Integrates nursing science, computer science, and
information science to manage and communicate data,
information, knowledge and wisdom into nursing
practice… facilitates the integration of data, information,
knowledge and wisdom into nursing practice. Facilitates
the integration of data, information, knowledge and
wisdom to support patients, nurses and other provides in
their decision-making in all roles and settings. This support
is accomplished through the use of information structures,
information processes, and information technology.”
(American Nurses Association)

24. APPLICATION OF NURSING INFORMATICS / GENERAL PURPOSE
Nursing Clinical Practice:
Work lists to remind staff of planned nursing interventions.
Computer generated client documentation.
Electronic medical record (EMR) and Computer based Patient
Record (CPR).
Monitoring devices that record vital signs and other
measurements directly into the client record (EMR).
Computer generated nursing care plans and critical pathways.
Automatic billing for supplies or procedures with nursing
documentation.
Reminders and prompts that appear during documentation to
ensure comprehensive charting.

25. Nursing Administration (Health care information
system)
Automated staff scheduling.
E-mail for improved communication.
Cost analysis and finding trends for budget
purposes.
Quality assurance and outcomes analysis.

26. Nursing Education:
Computerized record keeping.
Computerized assisted instruction.
Interactive video technology.
Distance learning- web based courses and degree programmes.
Internet resources- formal nursing courses and degree
programmes.
Presentation software for preparing slides and handouts- power
points and MS words.

27. Patient Education:
Nursing informatics can be used for symptom
management and patient education. The nurse can
access the information for the patient or teach the
patient where to find appropriate and helpful
information. For example, on an oncology unit,
nursing informatics can be used to teach patients
effective symptom management of the treatment
modalities which often cause pain, fatigue and poor
nutritional status. Nursing informatics can also aid in
other nursing interventions of the oncology nurse,
such as analgesic administration and stress-reduction
techniques.

28. Clinical Alert System:
The computerized clinical alert system
can be used in conjunction with the
hospital pharmacy. A system design is
created to alert both pharmacy and
health staff when two or more drug
prescriptions are incompatible.

29. Consumer
Informatics

30. Branch of medical informatics that studies the use of
electronic information and communication to improve
medical outcomes and the health care decisions. Making
process from the patient / consumer perspective.
(AMIA, May 3, 2007)

31. The Future:
 Help the clinicians to develop needed
competencies.
Develop and implement information
technology
Generate new knowledge
New roles with consumers
New technology-genomonics, wearable
monitoring devices, development in
educational technology.

32. Nursing informatics has arrived and the
baby has started to walk. In the process,
nursing informatics has introduced new
challenges and opportunities along with
new computer applications.
Nursing informatics is a growing field for
advancement and offers many potential
areas for cost containment.

33. Clients may receive
treatment in their own
community where
services cost less,
improving quality of care
and improved continuity
of care through
convenient follow-up.