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Importance of nursing informatics in health care delivery
NURSING INFORMATICS IN PHILIPPINES
• Nursing Informatics...
is the "science and practice (that) integrates nursing, its information and
knowledge, with management of information and communication
technologies to promote the health of people, families, and communities
• In 2008,Nursing Informatics course in the undergraduate curriculum was
defined by the Commission on Higher Education (CHED) Memorandum
Order 5 Series of 2008 but was later revised and included as Health
Informatics course in CHED Memorandum Order 14 Series of 2009.
• the inclusion of informatics as an integral part of the undergraduate
curriculum has been one of the most influential factors for the increased
awareness and interest in this field of nursing. However, the contents of
the curriculum was adapted from international materials which does not
match the local needs.
• 1. Advance nursing informatics education through partnerships with colleges of
2. Encourage hospital executives to ensure all practicing nurses adopt and
adhere to all policies and principles of the TIGER (Technology Informatics
Guiding Education Reform) Foundation Initiative.
NIT in the Philippines Brief history
- Headed by Dr. Alvin Marcelo, PMIS was officially registered under the
Securities and Exchange Commission in 1996 by its board composed of eleven
- Another challenge is, there are two generations of people. The young ones are
people that think differently and the old ones are the ones that are being
pushed by the young ones out of their practice.
• 3. Build a culture that supports nursing informatics through programs
organized around reward and recognition, professional development,
mentoring, performance planning and assessment, and career path
4. Develop nurses' potential to fulfill emerging informatics management
roles by focusing on leadership skills such as communications, strategic
and systems thinking, clinical, financial and business operations, and
Healthcare organizations can do much to support the evolving role of
nursing informatics. Among the recommendations from nursing leadership
FUTURE VISION OF NURSING
• Many nurses struggle in practice as they continue to try and apply habitual
communication practices in the new environment without any critical
reflection on, and adaptation of, those practices
ELECTRONIC BASED QUALITY IN PH
• RECORD-KEEPING or documentation is an essential part of nursing
practice that has clinical and legal significance at the same time. It is said
that quality documentation improves patient care which results in better
outcomes, while poor documentation often contributes to poor-quality
nursing care (Prideaux, 2011). Nursing documentation, a precursor to good
patient care, is a vessel for efficient interdisciplinary communication and
cooperation (Ammenwerth, Mansmann, Iller, & Eichstadter, 2003).
• Nurses in majority of healthcare facilities in the Philippines still practice
paper nursing documentation. A report of the Maryland Nursing Workforce
Commission (2007) revealed that such method of documentation reduces
the time spent at the bedside for patient care, thus directly affecting
outcomes. This is where Nursing Informatics comes in.
• Nursing Informatics “aims to improve the health of populations,
communities, families and individuals by optimizing information
management and communication” (ANA, 2001). It is fundamental in
providing cost-effective high-quality healthcare, of which an important
component is accurate clinical information
• Thede (2003) explained that electronic information systems provide an avenue
for more effective communication and collection of patient health information
resulting in more effective patient care. One example of such information
system is the electronic health record or EHR, where multiple systems that
cross to share data are networked to support efficient information management
and communication within a healthcare system. EHR is largely advantageous
because it tends to store large amounts of data that are made accessible at the
same time in different places. What makes this system more interesting is its
ability to provide healthcare teams with clinical alerts and reminders when
abnormal parameters are identified in both laboratory and assessment data.
• Electronic-based documentation systems would be of great value to
Philippine hospitals with a nurse-patient ratio higher than the ideal. When
the staffing ratio is high, nurses tend to allot more of their time
documenting rather than actually caring for their patients at the bedside.
In an electronic-based documentation system, trends in patient outcomes
will be highlighted alongside medical and nursing management
• Such systems, while integrating the concepts and theories of nursing science,
computer science and information science, propel the entire healthcare delivery
system into a practice that is evidence-based and culturally-relevant. These
systems should not be regarded as a substitute for clinical judgment or as a
predictor of critical illness but as a tool that could help identify life-threatening
• Though most of Philippine hospitals are quite far from achieving this, such
information systems should be viewed as a crucial facet in promoting a culture
of patient safety where the documentation standards help and/or equally meet
the standards of medical and nursing care.
ELECTRONIC HEALTH RECORD
• also known as “Electronic Medical Records or Computerized Patient
Records” are found more useful when the number of data being process are
highly prioritized and/or a large data are being stored . EHR provide the
ability to manage health impossible to apply to paper record keeping.
TYPES OF DATA STORED IN EHR
• An electronic health record should contain important data such as;
• Patient profile
• Results of medical examination
• Medical history
• Development of health condition and status
• Results of laboratory test
• Information about allergies, illness, immunization, dis order and diseases.
• Medicine taken and its compatibility with drug interaction
• Records of appointment
• Billing records
Illustrative Questions How to Use this Guide
What elements should I include in my
assessment of health care facility performance in
the country? • See Section I for a taxonomy of performance domains.
• See Section IV.A for principles on selecting measures to include in
• See Appendices 1-8 for examples of performance measures used in empirical
studies from World Bank client countries.
What standard should I use for judging how well
health care facilities in the country are
• See Section IV.B for guidance on several comparison methods for identifying
What metrics have been used to measure the
quality of health care facility management?
• See Appendix 2 to look up “Quality” under Domain and “Managerial quality”
under Dimension for a list of empirical studies with relevant metrics.
• See Appendix 8 for bibliographic references. Read original studies for details
on measurement methods and metrics.
What factors might be causing low performance
in health care facilities?
• See Section II for summaries of different disciplinary approaches to explaining
What strategies might be successful in
addressing nurses’ lack of motivation in
government-run health care facilities?
• See Section III for summary tables matching strategies to root causes and
conditions for effectiveness.
• See Sections IV.C and IV.D for recommended methods to determine root
causes and select suitable strategies.
How can I know if the performance
improvement strategy we are implementing is
• See Section IV.E for suggestions on study designs, data infrastructure, and
other prerequisites for effective monitoring of implementation progress and
Intermediate cccOutcome Domains
Dimensions Examples of Measures
• Adherence to clinical guidelines
• Avoidance of medical errors
• Availability of medical supplies
• Functional medical records system functional
• Patient satisfaction
EFFICIENCY • Cost-to-service ratios
• Staff-to-service ratios
• Patient or procedure volume
• Nurses or health workers per bed
• Inpatient or outpatient visits per day, per bed, or per health
Patient or procedure volume relative to capacity
Patient or procedure volume relative to population health
• Percent occupancy
• Outpatient visits per provider
• Percentage of pregnant women receiving antenatal care
• Physical access
• Financial access
• Linguistic access
• Information access
• Service availability / allocation
• Non-discriminatory service provision (equitable treatment
regardless of age, gender, race, ethnicity, religion, class, etc.)
• Geographic distance to facility
• Availability of transport to facility
• Hours of operation of facility
• Absenteeism of health care workers from facility
• Affordability of services
• Availability of culturally and linguistically appropriate services
• Data audit and feedback processes
• Innovation adoption
• Training/continuing education for healthcare workforce
• Use of balanced scorecard for organizational performance
• Presence of patient suggestion box
• System exists for nurses to report errors to hospital management
• Quality improvement methods used
• Political support
• Community and patient support
• Financial support
• Human resource supply
• Involvement of community leaders in facility planning and
• Use of strategic management process to promote organizational
fit with environmental conditions