A seminar on “NURSING INFORMATICS”.
Subject: Nursing Science and Theory development
including Nursing leadership
Guided by: Dr.Anu Gauba Presented by : Kh. Chetanmala Devi
Professor, Ph.D Nursing,
Amity College of Nursing, 1ST Semester,
Jan 2022-2026 batch
Dated: 26/05/2022
Objectives
At the end of the class, the group will be able to
Define nursing informatics
Understand the application of Nursing Informatics
Know the significance of Nursing Informatics
Explain about telenursing
Describe Nursing Management Information System
Identify the trends in Nursing Informatics
MEANING •
Informatics comes from the French word
“informatique” which means “computer science”.
Informatics is defined as computer
science+information science.
History
Usage of computers in health care began in 1950
Computers popular among nurses in 1970
The first certification exam for Nurse Informaticist was taken
in 1995 (Saba & McCormick).
DEFINITION
Hebda (1998), defines nursing informatics as the
use of computers technology to support nursing,
including clinical practice, administration, education
and research.
The American Nurses Association (ANA) identified nursing
informatics as “a specialty that integrates nursing science,
computer science, and information science to manage and
communicate data, information, and knowledge in
nursing practice” (ANA, 2001, )
Goal of Nursing Informatics
In 2008, ANA updated the Scope and
Standards of Nursing Informatics Practice.
ANA lists the goal of NI as:
“The goal of NI is to improve the health
of populations, communities, families, and
individuals by optimizing information
management and communication ”.
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.
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.
Nursing Education:
• Distance learning- web based courses
and degree programmes.
• Internet resources- formal nursing courses and
degree programmes, short courses.
• Presentation software for preparing slides
and handouts- power points and MS words
• Computerized record keeping
• Computerized assisted instruction
• Interactive video technology
Nursing Research:
• Computerized literature searching-
CINHAL, Medline and web sources.
• The adoption of standardized language
related to nursing terms-NANDA etc.
• Data analysis-SPSS.
• Patient Education:
• 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
Contd..
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.
Patient Data:
Nursing informatics can also be useful in a physician’s clinic.
In a managed care environment, information systems make
administrative management more efficient.
The private practitioner, program or facility to manage every
aspect of patient care can use one data management system.
In each of these health care
settings data management
systems can be applied to
treatments, diagnostics,
documentation, practice
management, insurance claims
and referrals and protocols as
well as treatment and
diagnostics results.
Contd..
Telehealth:
• Telehealth includes the use of telephones and
sophisticated image transmission systems like ECG,
faxes and remote camera imaging.
Telehealth places the
ambulance personnel in
touch with the Emergency
Department and it also
operates to put the generalist
“nurses and doctors” at the
ED in touch with specialists.
Clinical Information:
Clinical practice guidelines can be
found at
http://www.nhlbi.nih.gov/guidelines/in
dex.htm. The practice guidelines
found at this site provide management
information for asthma, cholesterol,
hypertension and obesity.
Clinical practice guidelines for the
management of diabetes mellitus and
menopause can be found at
http://www.aace.com/clinguideindex.htm.
Further information can be found through the
Medscape Nurses site and National Institute of
Health- http://www.nih.gov.
SIGNIFICANCE OF NURSING INFORMATICS
Facilitates communication
Allows articulation of
organized information
Leads to credibility.
• Increased time for client care: more time is
available for client care because less time is
required for documentation and
transcription of physician orders.
• Facilitation of data collection for research:
electronically stored client records provide
quick access to clinical data for a large number
of clients.
Improved communication and
decreased potential for error:
improved legibility of
clinician documentation and
orders is seen with
computerized information
systems.
Creation of a lifetime clinical record
facilitated by information systems.
Data related to treatment such as inpatient
length of stay and the lowest level of care
provider required can be used to decrease
costs.
Extensive financial
information: can be
collected and analyzed for
trends. An extremely
important benefit in this era
of managed care and cost
cutting.
SPECIALTY EDUCATION AND CERTIFICATION
American Nurses Association recognized
Nursing Informatics as an speciality in
1992 and began certification in 1995.
ANA defined Nursing Informatics ,
outlined roles and responsibilities and
developed standards for practice.
Two certifications available for specialization in
nursing informatics
1) The first is through the American Nurses
Credentialing Center (ANCC). The ANCC exam is
specific for the informatics nurse. The applicant must
be a licensed registered nurse (RN) with at least 2
years of recent experience and have a baccalaureate
degree in nursing (BS/BSN). The applicant must
have completed 30 contact hours of continuing
education in informatics
Contd..
2) The second certification exam is
sponsored by HIMSS ( Healthcare
Information and Management Systems
Society). Candidates who successfully
pass this exam will carry the designation
of certified professional in healthcare
information and management systems
(CPHIMS).
USE OF COMPUTERS
HOSPITALAND COMMUNITY
CLINICAL IMPLICATION
• Assessment
• Patient monitoring
• Documentation
• Nursing minimum data sheet
• Telemedicine
• Electronic Medical Records (EMR)
ADMINISTRATION:
• Provision of data required by the nurse administrators
to:
Define the cost of nursing services.
Evaluate quality assurance programme.
Demonstrate the cost effectiveness of nursing care
Justify new roles for nursing in the health care
system
NURSING PRACTICE:
• Enhance documentation by the nurse.
• Provision of data to enable research directed at
examining relationship between data elements and
nursing outcomes to identify optimal nursing care
for use in practice.
• Facilitate nursing process through use of the
NMDS(Nursing Minimum Data Set) in practice.
• Nursing workload measurement system:
The three most widely used nursing
workload measurements are:
Project research in nursing:
Medicus.
GRASP (Grace- Reynolds application)
RESEARCH
• The advent of computerized data bases of
literature helps to search rapidly and to
retrieve abstracts of literature immediately.
• Conduct online searches of data base.
• Provides online full text information on
legal, news, business and general
information. Eg: CINAHL, Medline, Science
Direct.
• Preparation of research document
• Data gathering:
Computer self administered interviewing,
Computer assisted telephone interviewing:
• Data analysis: eg SPSS software
COMMUNITY SETTING
The main uses of computers in
community are:
• Gathering of epidemiological and
administrative statistics.
• Patient appointments- identification
system.
• Patient assessment and data gathering.
• Monitoring.
• Documentation.
• Special need application.
PATIENT RECORD SYSTEM DEFINITION
A ‘medical record’ is a patient record,
consisting of sufficient data written in sequence
of events to justify the diagnosis and warrant
treatment and end results. It must be adequately
informative, highly scientific and legally
protective.
It may be defined as a clinical, scientific,
administrative and legal document relating to
the patient’s care.
IMPORTANCE OF MEDICAL RECORDS
To the patient It helps in the following ways: –
- document the history of the patient’s illness.
–avoid omission and unnecessary repetition of diagnosis and treatment
measures.
– It assists in the continuity of care in the event that future illness
requires attention in or out of the hospital.
–evidence to support or to refute any legal questions.
– It assists the patient and authorities concerned in fixing disability
entitlements under the Workman’s Compensation Act.
To the hospital
- The medical records form the basis of many
phases of administrative efficiency
– It provides the management with statistical
information necessary for decision making with
regard to utilization of resources, planning for
administrative control and future references.
– It also furnishes documentary evidence
for purposes of evaluation of hospital care
in terms of quality, quantity and adequacy
(medical audit).
– It protects the hospital in the event of
legal questions (Torts suits).
To the doctors
– It assures the doctor of the quality and adequacy of the
diagnostic and therapeutic measures undertaken by him.
– It assures the doctor of the continuity of medical care.
– It helps the doctor in self evaluation.
– It protects the doctor in case of legal suits.
• To the public health authorities
It provides a reliable mortality and morbidity
statistics and thus helps the public health
authorities to plan preventive and social
measures to meet the needs of the community.
Early warning of the incidence of
communicable diseases is often obtained from
hospital records.
To medical education and research
• Since recorded observations and case studies are the basis of all
clinical research, medical records become invaluable in all research
and teaching programmes.
CHARACTERISTICS OF GOOD PATIENT
RECORDS
• Complete: Sufficient data to identify the patient,
justify diagnosis and warrant treatment and outcome.
• Adequate: All necessary forms and all relevant
clinical information.
• Accurate: Capable of quantitative analysis.
COMPUTERIZED PATIENT RECORD
Advantages of CPR:
• Have the patient’s entire history.
• Can flag drug reaction problems.
• Can eliminate redundancy in
record keeping.
• Eliminate the need for taking
repeated histories.
• Can, if utilized properly, reduce
error.
Disadvantages Of Computerized Patient Record :
• Are very expensive to set up.
• Are less secure.
• Require standardized coding systems,
which force all users to use entries that the
computer can understand.
What Is Telenursing?
Telenursing — or telehealth nursing — uses technology to
provide nursing services through computers and mobile devices.
As mobile devices become more common and accessible,
telehealth is becoming more prevalent as a healthcare option
Telenursing Benefits
1) Remote Service Delivery
Telehealth technology allows nurse
practitioners (NPs) to deliver medical
services via the internet and mobile
devices. NPs deliver services using
various tools, such as computers, remote
monitoring devices, cellular devices, and
delivery companies.
2) Financial Savings
Telenursing can reduce costs for both patients and
practitioners. Savings also include reduced visitation
expenses and productivity gains from decreased
employee absences.
3) Improved Bed Allocation
By improving follow-up care to high-risk clients —
such as chronic illness sufferers and recent surgical
patients — healthcare providers have found that
telenursing offers a tool that reduces readmissions
considerably.
4) Patient Comfort
According to a study of Massachusetts General Hospital
telehealth patients, published by The American Journal of
Managed Care, most patients felt virtual health visits were more
convenient than in-person visits, more than 60% felt virtual visits
were no different in quality from in-person visits, and more than
80% would recommend virtual visits to family and friends.
5) Increased Healthcare Employment Opportunities
Insurers
Consultations.
Analysts
6) Accessibility by Patients in Remote Areas
With telehealth services, rural hospitals can reduce costs, cover larger areas,
and eliminate most of the time it takes to deliver services.
NURSING MANAGEMENT INFORMATION
SYSTEM
Nursing Information systems
(NIS) are computer systems that
manage clinical data from a
variety of health care
environments, and made available
in a timely and orderly fashion to
aid nurses in improving patient
care.
Advantages of NIS
1) In Nursing administration
Evaluate quality assurance programs
Defend resource allocation to nursing
Demonstrate the contribution to nursing
Identify outcomes of nursing care
2) In nursing practice.
Enhance documentation by nurses
Provide data to enable research directed
at examining the inter relationships
between data elements and nursing
outcomes.
Facilitate development of nursing
process
3) Nursing research
To assess variables on multi levels
including institutional, local, regional
and national.
Identify trends to build information
and to further synthesize to develop
nursing knowledge
4) Nursing education
To develop body of knowledge
with focus on nursing process
To enable staff educational needs
based on follow up care and
outcomes.
To enhance student nurses
accurate documentation.
Disadvantages of Health Informatics
Expensive
Requires
time to
adapt
Over-
dependency
Susceptible
to network
hackers
TRENDSIN NURSINGINFORMATICS ANDHEALTHCAREANALYTICS
While new advancements in health care technology are emerging
every day, three primary trends have transformed the health system.
These health care tech trends include:
a) Electronic Health Records (EHR)
b) Remote Health Care Devices & Care
c) Mobile App Technology
a) Electronic Health Records (EHR)
EHRs are digital patient records that can be
instantly and securely shared among various
health care practitioners and organizations.
EHRs include all documents related to patient
care, including medical history, diagnoses,
allergies, lab reports, and prescriptions.
EHRs provide:
Quick and secure access to real-time patient information
Streamlined communication between different health
care organizations
Consistent documentation minimizing the risk of
potential errors
Enhanced connectivity with insurance companies and
government agencies
Simplified chart storage, management, and transmission
Increased overall speed and efficiency
b) Remote Health Care Devices & Care
Wearable devices.
Provide doctors and nurses with a live stream of
real-time patient data
Can lower health care.
Offer patients with disabilities and chronic
conditions support and greater independence.
c) Mobile App Technology
mHealth apps range from fitness and wellness tools that can
record almost every activity that you do to specialized medical
apps, including retinal scans and medical-grade EKG monitors.
Many hospitals and clinics have mobile app
technology for communicating with patients,
posting lab reports, sending messages from the
medical team, and scheduling appointments.
Helps minimize time spent filing, maintaining
records, and performing tedious administrative
tasks.
Conclusion
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.
Nursing informatics and managed care, make telehealth an
attractive tool to save healthcare dollars
Summary
Nursing informatics as the use of computers technology to support
nursing, including clinical practice, administration, education and
research.
Nursing informatics is applied in Nursing Clinical Practice, Nursing
Administration , Nursing Education, Nursing Research
Telenursing and electronic medical records are very important during
this covid pandemic
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