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Theories, Models, and
Frameworks
NURSING INFORMATICS
NURSING INFORMATICS
Is an established and growing area of
specialization in nursing

All nurses employ information
technologies in their practice.


Computers are incredibly fast , accurate
and stupid.

Human beings are incredibly
slow , inaccurate and
brilliant .

Together they are powerful beyond
imagination

Albert Einstein

Why do we NEED to study N.I?
In the 21st Century, information is
doubling every 5yrs , if not tripling in
quantity and quality.
Information is POWER
Technology also facilitates the
creative process in nurses, affording
amazing vehicles for patient
education, teaching and learning, and
providing general health promotion
and prevention information on a
global scale.
This can only become a common
reality if nurses are comfortable
working with computers and
advanced technology while providing
evidence based care for their clients .
The healthcare of our clients is
largely dependent on information.
Every action taken depends on
previous information and knowledge.

THE HIGH TECH AND THE HIGH
TOUCH
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WHAT DO WE NEED TO ACHIEVE
NURSING INFORMATICS?


SOFTWARE
HARDWARE PEOPLE
Nursing practice will be
revolutionized and we will
truly be a profession of
nurses with our own
classification systems,
bibliographic systems, and
payment systems .
We need to think outside the box?

We need to use the Internet to enhance
our practice and provide tele-nursing care
. We need to become wireless and conduct
our services using all the newer IT tools.

We have a long way to go, but if we
utilize information technology effectively,
informatics will become an integral part of
our profession and the health care
industry. I do believe we have the
knowledge and perseverance and I am
convinced it will come to pass.-Dr.
Virginia Saba
What is informatics
1957 - First coined by Karl
Steinbuch as informatiks.
1962 Phillipe Dreyfus used
informatique
Walter Bauer translated it into
informatics

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What is informatics
Combined the terms information
and automation which means
automatic information processing.
What is informatics
A science that combines a domain
science, computer science,
information science and cognitive
science.

Multidisciplinary science drawing from
varied theories and knowledge
applications.
What is informatics
a broad academic field encompassing
human-computer interaction,
information science, information
technology, algorithms, and social
science
What is informatics
Computer science, the study of
complex systems, information and
computation using applied
mathematics, electrical engineering
and software engineering techniques.
What is informatics
Information science is the
study of the processing,
management, and retrieval of
information
In 1980, Scholes and Barber applied
this new term to the art and science
of nursing, coining the term,
nursing informatics, which they
defined as ...the application of
computer technology to all fields of
nursing-- nursing services, nurse
education, and nursing research.
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WHAT IS HEALTH INFORMATICS?
HEALTH INFORMATICS
Integration of healthcare sciences,
computer science, information
science, and cognitive science to
assist in the management of
healthcare information.
A subdiscipline of informatics
ACTIVITY
Present an illustration using the
description delineating Health
Informatics and its sub disciplines.
Health informatics have subdomains
such as medical informatics, dental
informatics, pharmacy informatics,
nursing informatics, etc.
Each of these subdomains have
integrated content and which are
collaboratively working with each
other.
ACTIVITY
Limit your illustration using only
circles, squares and arrows and texts.
Use any application (paint, Msword,
Ppt) in making your diagram.
Finally present the illustration using
powerpoint.
Further explain your diagram.
CORRECT

HEALTHINFORMATICS
DentalInformatics
Nursing Informatics
Pharmacy Informatics
MedicalInformatics
NURSING INFORMATICS
1985 Kathryn Hannah;..is the
use of information technologies in
relation to any nursing functions.


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NURSING INFORMATICS
1989 Graves & Corcoran .. Is a
combination of computer science,
information science and nursing
science designed to assist
management and processing of
nursing data, information, and
knowledge to support the practice of
nursing and the delivery of nursing
care.


NURSING INFORMATICS
1994 ANA .. 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, research
and the expansion of nursing
knowledge.


NURSING INFORMATICS
2001 ANA .. a specialty that
integrates nursing science,
computer science, and
information science to manage
and communicate data,
information and knowledge in
nursing practice


NURSING INFORMATICS
2001 ANA .. facilitates the
integration of data, information, and
knowledge to support patients,
nurses, and other providers in their
decision-making in all roles and
settings. The support is
accomplished through the use of
information structures, information
processes, and information
technology
SCOPE OF PRACTICE
P RACTICE
E DUCATION
R ESEARCH
A DMINISTRATION
NURSING
INFORMATICS
SCOPE
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Standard Areas of NURSING:

Nursing P ractice
Nursing E ducation
Nursing R esearch
Nursing Administration
COMPUTERS IN NURSING EDUCATIONS
COMPUTER Assisted Education
PDA (Personal Digital Assistants)
LCD Projectors
Wireless Routers
Desktops
Laptops
Smartphone
VIDEOS/ANIMATIONS
Distance learning
Testing (NCLEX)
Student and course record
management
COMPUTERS IN NURSING PRACTICE
Functions
Records client information
Provides access to other departments
Used to manage client scheduling


COMPUTERS IN NURSING PRACTICE
DOCUMENTATION OF CLIENT STATUS
AND MEDICAL RECORDS KEEPING
Provides access to standardized forms,
policies and procedures
Access data about client that may be
somewhere in the medical record or
elsewhere in health care agency.


BEDSIDE DATA ENTRY
records clients assessments, medication
administration, progress notes, care plan
updating, client acuity and accrued charges

COMPUTER BASED CLIENT RECORD
EMRs/CPRs
Provides easy retrieval of specific data
such as trends in vital signs,
immunization records, current problems
It can be designed to work providers
about conflicting medications or client
parameters that indicate dangerous
conditions
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ELECTRONIC ACCESS TO CLIENTS
Used extensively in health care to
assess and monitor clients
conditions
Data accumulated from various
electronic devices are stored for
research purposes
Can monitor client
Computerized diagnosis
Telemedicine
PRACTICE MANAGEMENT
Used to order supplies, tests, meals,
and services, from other departments
Allows nursing service to determine the
most costly items used by a particular
nursing unit.
May provide information or decisions
to modify budget, provide different
staffing, move supplies to different
locations, or make other changes for
more efficient and higher quality care


COMPUTERS IN NURSING PRACTICE
A. Human resources
All employers must maintain a data a database on
each employee
Administrators can use this database to
communicate with employees, examine staffing
patterns, and create budget programs
B. Medical records management
Allow client records to be searched for trends,
number of cases, most expensive cases, and client
outcomes.
Nurse informaticist can assist administrators with
the design and implementation of systems that allow
such searches to be generated, analyzed, printed,
and distributed.
C. Facilities management
heating, air conditioning, ventilation,
alarm systems are computer controlled.

D. Budget and finance
claims are transmitted much more
quickly
Can also effect cost-savings by reducing
the desired services time needed for
accounts payable and receivables.

COMPUTERS IN RESEARCH
1. problem identification
Useful in locating current
literature about the problem and
related concepts
Helps in searching for existing
documents, and e-mail to
colleagues.
2. literature review
Software facilitate searches,
contains thesauruses so that the
most appropriate terms can be
selected.

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COMPUTERS IN RESEARCH
3. research design
Search literature for instruments that have
already been established or to design and
test instruments that need to be developed
for past study.
4. Data collection and analysis
Helps create form for the collection of data
such as informed consent, demographic
data, and recording forms.
Commonly used software for quantitative
data analysis: SPSS ( statistical package for
social sciences), SAS ( statistical analysis
system), Sys STAT, MYSTAT
5. Research dissemination
computer word processing programs are
used to author the final reports of research
and send research to various readerships.
Help speeds completion or research projects


NI as a SPECIALTY
1992 ANA established nursing
informatics as a distinct specialty
in nursing with a distinct body of
knowledge.
INDIVIDUAL ACTIVITY
Use a Word Processor
Explain how nursing informatics is
considered as a distinct specialty.
Specifically describe the role of
informatics nurses compared to
nurses of other fields of nursing.
200 words minimum..

INDIVIDUAL ACTIVITY
Use a Word Processor
Use Times New Roman
Font Size: 12.5
Line Spacing: 1.5
1 tab indent each paragraph
Justify each paragraph
Margins: 0.75 top, 0.75 bottom, 1 left; 1
right.
Orientation: Portrait
Paper Size: Long Bond Paper
Title at Center (Make your own)
Save File: Act1YourName.doc

Informatics Nurse Specialists
Is a professional with a formal RN
graduate degree and passed the
credentialing in nursing informatics of
a state.
Informatics Nurse Specialists
Nursing informatics specialists
practice in a wide variety of roles that
are ultimately aimed at improving
patient care delivery and the nursing
practice experience.
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Informatics Nurse Specialists
Some of those roles are:
Project manager
Educator
Product developer
Decision support/outcomes manager
Systems analyst
Consultant
Programmer
Advocate/policy developer
Web developer
CIO, CEO, CNO
Entrepreneur
Researcher
Sales and marketing
COMPONENTS of PRACTICE
Transformation of Data to Wisdom

Data discrete entities that are described
objectively without interpretation.
ex. A systolic blood pressure, a nursing
intervention, a patient problem, an
outcome
COMPONENTS of PRACTICE
Transformation of Data to Wisdom

Information reflects interpretation,
organization, or structuring of data.
- are processed data
- data with meaning
COMPONENTS of PRACTICE
Transformation of Data to Wisdom

Knowledgetransformation of
information.
- information that is synthesized so
that relationships are identified and
formalized
COMPONENTS of PRACTICE
Transformation of Data to Wisdom

WISDOMhighest form of data
transformation.
- is the application of ethics in using
knowledge.
COMPONENTS of PRACTICE
C
o
m
p
l
e
x
i
t
y

HumanIntellect
Data
Information
Knowledge
Wisdom
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REGISTERED NURSES as KNOWLEDGE
WORKERS
Knowledge work is the exercise of
specialist knowledge and
competencies.
SCREEN CASTING
Create a powerpoint presentation of your
report.
Using the powerpoint report record as
video + audio and edit the report for
screencasting. Record the narration like
you are explaining your slides on class.
Utilize your knowledge on video editing.
Maximum minutes of screencast is 10
minutes only.
Number of members per group = 3..no
exceptions.
COMPETENCIES
Research; Article search (Use of
internet)
Staggers, Gassert, and Curran, 2001
ANCC
Informatics Exam Content
HIMSS (Healthcare Information and
Management Systems Society)
TERMINOLOGIES
What is the use of standard
terminologies/languages?
What is a data set?
What is nursing minimum data set
(NMDS)?
Enumerate the different ANA-
recognized terminologies.
Describe each briefly.
TENETS
Distinct specialty practice and body of
knowledge

Includes both clinical and non-clinical

Supports nurses to improve quality of care
and welfare of health care consumers

Focus is delivering right information to right
person at the right time

TENETS
Human factors concepts are interwoven in
practice

Ensure confidentiality and security of data and
information and advocates privacy

Promotes innovative, emerging and established
information technology

Collaborates with and is closely linked to other
health-related informatics specialties
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ELECTRONIC HEALTH RECORD ELECTRONIC HEALTH RECORD
any information related to the past,
present, or future physical/mental
health, or condition of an individual.
The information resides in electronic
system(s) used to capture, transmit,
receive, store, retrieve, link, and
manipulate multimedia data for the
primary purpose of providing
healthcare and health related
services..
ELECTRONIC HEALTH RECORD
Increased patient safety: All information
about the patients existing conditions,
allergies and drug intolerances is available
when Physicians need it, where they need it
so that they can make the best decisions for
their patients.
Increased efficiency: A single source of
accurate patient data means Physicians don't
need to spend time logging in to different
specialist clinical systems or contacting
other healthcare institutions for information.

ELECTRONIC HEALTH RECORD
Trend and data analysis: A central
clinical repository of clinical information
means that information can be mined
and analyzed to contribute to more
effective healthcare delivery in the
future, and can give a better
understanding of trends, patterns and
epidemiology in public health.

HIPAA and Technology
Influx of new technology is creating
implications for the protection of
privacy and security.
Simple precautions to secure client
info:
Use data encryption
Use password when logging on, and a
time-out to reactivate the password
If using PDA, disable the infrared ports
Privacy Confidentiality Security
The role of staff nurses as the protector
of patient information is becoming
more crucial as more health care
information becomes part of the
medical record and as it becomes more
available electronically instead of on
paper.

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Privacy Confidentiality Security
The staff nurse may be ask to provide
information such as a printed medical
administration list from an electronic
medical record to the patient, the
patients family member, a medical
student, or an attending physician.

Accountability among nurses is highly a
concern.
Privacy Confidentiality Security
is a means of protecting health
information so that it is not used or
disclosed except as authorized by the
individual. It protects the privacy of the
individual.

Privacy Confidentiality Security
means that information,
once allowed to be disclosed by the
individual, will not be shared without the
permission of the individual thereby
keeping it confidential.

Example: Nurses should not talk to
anyone except those under privileged
communication regarding patients
information, including security
information.
Privacy Confidentiality Security
is a means by which data is
stripped of identifiers that might
otherwise be used to identify a given
individual.
Ex. Use of passwords and PIN Codes
What is a Clinical Information System
(CIS)?
Collections of Information Technology
Applications equaling a repository
(database) of information for client care
Contains information about client history
of illness, interaction with providers,
genetic, environmental and social data
Creates record of status of decisions,
actions underway and information to assist
in performing targeted actions
What is an Electronic Record (EHR)?
Other common names
computerized patient record
(CPR), electronic medical
record (EMR) and the
electronic patient record (EPR)
Part of CIS
Resides in a software program
providing the health provider
an instrument to obtain
clinical information and
transcribe data into the
computer
Classified in three groups: (1)
Office Based (2) Web-based (3)
Handheld or Wireless System


ADVANTAGES
- Instant Access
- Legibility
- Safer data (protects from loss)
- Confidentiality
- Flexible Layout
- Integration with other info
resources
- Electronic data
- Continuous data processing
- Assisted Search
- Tailored Paper Output
- Always Current!

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Clinical DSS focus in EHR for Nurses
CPOE Computerized Prescriber Order
Entry



BCMA Bar Code Medication
Administration
Integrated EHR Features
Digital Imaging (Laboratory
Informatics)
Integrated EHR Features Integrated EHR Features
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Integrated EHR Features
Nursing Documentation
Integrated EHR Features
Nursing Documentation