Nursing Informatics

Ann Shepard, RNC, MSN

Director, Customer Support Services
Information Technology
Mercy Medical Center-Des Moines
 Objectives
Introduce Nursing Informatics
Certification for Nursing Informatics
Application of Nursing Informatics
Future of NI
 How it all began….
Late 1960’s first computer systems were
implemented in hospitals
Computer nurses began to appear in hospitals
Excellentclinicians
Technically curious and willing to try new things
 …or did it?
The First Informatics Nurse?
 “In attempting
to arrive at the truth, I have applied
everywhere for information, but scarcely an instance
have I been able to obtain hospital records for any
purposes of comparison. If they could be obtained, they
would enable us to decide many other questions besides
the one alluded to. They would show subscribers how
their money was spent, what amount of good was really
being done with it, or whether the money was not doing
mischief rather than good.”
 NI as a specialty
Disconnected parts
Roles, titles, and responsibilities varied
Definitions similar, conceptual models
considered, research in varied directions, all
good—standard languages
Panel assembled to help sort out the pieces
 Definitions
1989—Graves and Corcoran defined Nursing
Informatics as
“Computer science, information science, and nursing
science combined to assist in the management and
processing of nursing data, information and
knowledge to support the practice of nursing and the
delivery of nursing care.”
Image, p. 227
1996—Turley defined Nursing Informatics as the
intersection point with Nursing Science,
Computer Science and Information Science.
1995—Graves et al, began to incorporate
knowledge as a product of the sciences into the
definition.
 National Center for Nursing
Research
 Began in 1988
 Noted scholars met to discuss priorities for nursing research
 Dr. Gloria Bulechek, Dr. Judith Graves, Dr. Susan Grobe
 Dr. Kathryn Hannah, Dr. Norma Lang, Dr. Judy Ozbolt, Dr. Wm Paisley,
Elliott Roberts, Dr. Samuel Schultz, and Rita Zielstorff
 Determined ‘Criteria for Promising Dimensions’
 Group discussed early needs for standardization of data sets,
taxonomy to classify and allow for use of a common language
 Developed seven focus areas for Nursing Informatics
» NCNR 1993
» Reference available on line:
http://www.nih.gov/ninr/research/vol4/Overview.html
 American Nurses Association
Recognized as a specialty in 1992
Defined NI, outlined roles and responsibilities and
developed standards for practice.
Certification for generalist

www.ana.org
ANCC (American Nurses Credentialing Center)
 American Nurses Association
1994, Scope of Practice for Nursing Informatics
“Nursing Informatics is the 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”.
 ANA today
2001, Scope and Standards of Nursing
Informatics Practice
NIis an evolving field—expect change in definitions
Three categories of definitions
 Technology focused
 Conceptually focused
 Role-Orientated

To order or for additional info on the booklet: www.nursebooks.org (part of the ANA web
site)
 New Definition -- ANA
 “Nursing Informatics is a specialty that integrates nursing
science, computer science, and information science to
manage and communicate date, information, and
knowledge in nursing practice. Nursing informatics
facilitates the integration of data, information, and
knowledge to support patients, nurses, and other providers
in their decision-making in all roles and settings. This
support is accomplished through the use of information
structures, information processes,and information
technology.”
 ANA (2001)p. 17
 Certification
Began in 1995
First computer based exam—able to take at any
time at any approved testing location
Knowledge expected of a NI generalist
Focus areas of knowledge—from the NCNR
recommendations for focus
 Exam Focus Areas
 System Analysis and Design
 System Implementation and Support
 System Testing and Evaluation
 Human Factors
 Computer Technology
 Information/Database Management
 Professional Practice/Trends and Issues
 Theories
 System Analysis and Design
Conducting need and feasibility assessments
Process flow charting
Understanding requirements
Quality management and customer satisfaction
concepts
 System Implementation and
Support
Project management strategies
Policies and procedures
Education and training
Communication
Vendormanagement
Customer expectations
 System Testing and Evaluation
Willit do what we hoped it would for the costs we
thought in the time frame we planned?
This is our strength--assessment
Design process
Testing the system
Reviewing output of the system—reports
Measurement of pre-system goals
 Less time, more efficiently, legibility, accurate data, single
entry, etc
 Human Factors
Ergonomics
Right tool for the location, the care delivered, the
care provider
Screen flow, use of data for decisions
 Computer Technology
Understanding of the actual technology
Networks

Personal computers
Portable devices

Operating systems

Software
 Information/Database
Management
Understand database architecture—how data is
stored and accessed
Nursing structure
Nomenclature/vocabulary

Taxonomies and Coding Schemes

 ICD-P, CPT
Nursing Minimum Data Sets
 NIC,NOC, NANDA,
 Theories
Nursing Communication
Management Systems
Information
Computer
Behavioral
Change theory
Organizational behavior
Learning
 Professional Practice/Trends
and Issues
Ethics
Privacy
Roles of NI
ProjectManager Researcher
Educator Consultant
Advocate/Policy Developer Product Developer
Decision Support / Outcomes Manager
 Future of Nursing Informatics
Emerging roles
CIO, Entrepreneurs, Product Developers, Web
design, Independent Consultants
Challenges
Integration of data—duplication often
Inability to access data for decision making

Unique distinctions between roles has not been

defined--competencies
Questions?
 References
 American Nurses Association (ANA). (1996). The scope of
practice for nursing informatics. Washington, DC: Author
 American Nurses Association (ANA). (2001). Scope and
standards of nursing informatics practice. Washington, DC:
Author.
 Graves, J.R. & Corcoran, S. (1989). The study of nursing
informatics. Image, 21(4), 227-231.
 Graves, J.R., Amos. L.K., Huether, S., Lange, L., and
Thompson, C.B. (1995). Description of a graduate program in
clinic nursing informatics. Computers in Nursing,13, 60-70.
 National Center for Nursing Research (NCNR). (1993).
Nursing informatics: Enhancing patient care: A report to
the NCNR priority expert panel on nursing
informatics/national center for nursing research. NIH
Publication No. 93-2419. Bethesda, MD: U.S.
Department of Health and Human Services.
 Turley, J.P. (1996). Toward a model for nursing
informatics, Image, 28(4), 309-313.